Kyla Broeker Witt, MA, LPC
Individual provider Active NPI Professional Counselor · Troy, MO
NPI 1295874584 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1295874584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2002010834 (MO)
- Practice address
- 47 Ellis Ave
Troy, MO 63379-1151 - Phone
- (636) 357-1996
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowered Through Counseling | Professional | Current |
Accepting new patients |
| Collaborative Counseling, LLC | Past | Accepting new patients | |
| Dragonfly Wellness, LLC | Professional | Past |
Accepting new patients |
Locations
47 Ellis Ave
Troy, MO 63379
Phone (636) 357-1996
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2002010834 | MO | Yes |
Addresses
Primary practice location
47 Ellis Ave
Troy, MO 63379-1151
Mailing address
47 Ellis Ave
Troy, MO 63379-1151
Phone (636) 357-1996
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 495771313 | Medicaid | MO |
Other providers in Troy, MO
- Betty Ann Bockhorst
- Charlene Bockhorst
- James Lee Bockhorst
- Kelsey Bockman
- Sally Ann Breen
- Zachary Taylor Brown
- Jennifer Bryant
- Kaitlyn Burkemper
- Cathleen Burks
- John Martin Carmody
All providers in Troy, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.