Kylie Kathleen Maynard

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

208000972 Issued in IL

Practice address

409 Illinois Ave Unit 1D
Saint Charles, IL 60174-2966

Phone

(855) 205-4764

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1194417899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 ILLINOIS AVE UNIT 1D",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742966",
            "telephone_number": "855-205-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 ILLINOIS AVE UNIT 1D",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742966",
            "telephone_number": "855-205-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "KYLIE",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "208000972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Matthis, SOCIAL WORKER
• Bridgette Alexandra Maurino, LCSW
• Thomas Joseph Maurovich, DDS
• Melissa Elaine Mauthe, MSW, LCSW
• Brent Maxwell, D.C.
• John Mazzocco, DDS
• Lindsay McAndrews, LMFT
• Megan Jean McAvoy, PHARMD
• Anna McCaffrey, LCPC, NCC
• Diane Leone McCarthy, MA, CCC-SLP/L

• Mental Health Counselor in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.