Active NPI
Kyle Steven Kittleson, PSYD
- Psychologist
- West Lafayette, IN
National Provider Identifier
1427577485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20042637A
- Practice address
- 601 Stadium Mall Dr FL 2
West Lafayette, IN 47907-2052 - Phone
- (765) 494-6995
- NPI assigned
- Sep 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20042637A | IN | Primary |
Addresses
Primary practice location
601 Stadium Mall Dr FL 2
West Lafayette, IN 47907-2052
Mailing address
817 S 12TH St
Lafayette, IN 47905-1415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042637A | IN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505088000000",
"number": "1427577485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 S 12TH ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479051415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DR FL 2",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072052",
"telephone_number": "765-494-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTLESON",
"first_name": "KYLE",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-11",
"last_updated": "2017-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20042637A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.