Individual
DR. KYLE EVAN BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP, BCBA
Contact information
Practice address
550 THORNTON PKWY UNIT 234, THORNTON, CO 80229-2167
(720) 459-7493
Mailing address
1541 WABASH ST, DENVER, CO 80220-2143
(720) 468-9654
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-60816
CO
103T00000X
Psychologist
Primary
PSY.0006420
CO
103TC0700X
Clinical Psychologist
Primary
PSY.0006420
CO
Other
Enumeration date
07/12/2024
Last updated
05/14/2026
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