Individual provider Active NPI

Kyle Matthew Flaherty, M.S., LPC

  • Professional Counselor
  • Montgomery, AL
National Provider Identifier
1598014748
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3416 Issued in AL
Practice address
1040 Longfield CT
Montgomery, AL 36117-8055
Phone
(334) 288-9009
Fax
(334) 288-9497
NPI assigned
Sep 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C1966A AL
Professional Counselor 101YP2500X 3416 AL Primary

Addresses

Primary practice location

1040 Longfield CT
Montgomery, AL 36117-8055

Mailing address

1040 Longfield CT
Montgomery, AL 36117-8055
Phone (334) 288-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424002764 AL Practitioner - Mental Health Counselor 8729428750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gardenia Cove Mental Health PCGroup PAC ID 0648534537, 40 clinicians

Practice addresses (Care Compare)

7475 Halcyon Pointe Dr
Montgomery, AL 36117-8053
Phone (334) 954-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C1966AALMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gardenia Cove Mental Health PC CurrentSince Feb 10, 2024 Accepting new patients

Locations

7475 Halcyon Pointe Dr
Montgomery, AL 36117
Phone (334) 954-6010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1598014748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 LONGFIELD CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178055",
            "telephone_number": "334-288-9009",
            "fax_number": "334-288-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 LONGFIELD CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178055",
            "telephone_number": "334-288-9009",
            "fax_number": "334-288-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHERTY",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "M.S., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-04",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "C1966A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.