Individual
MR. KYLE JAMES SMYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LADC
Contact information
Practice address
7766 HIGHWAY 65 NE, SPRING LAKE PARK, MN 55432-2832
(763) 205-4843
(612) 416-2085
Mailing address
141 4TH ST E APT 1122, SAINT PAUL, MN 55101-2524
(651) 207-9860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305110
MN
101YM0800X
Mental Health Counselor
Primary
4377
MN
Other
Enumeration date
12/28/2018
Last updated
07/24/2024
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