Individual
KYLE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP, LAC
Contact information
Practice address
11285 HIGHLINE DR, NORTHGLENN, CO 80233-3076
(303) 853-3500
Mailing address
1870 W 122ND AVE STE 100, WESTMINSTER, CO 80234-2075
(303) 853-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PSY.0005396
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000188678
—
CO
Enumeration date
07/26/2017
Last updated
07/21/2022
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