Kyle M Kornbau, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

S7714 Issued in NC

Practice address

1101 Pemberton Hill Rd Ste 103
Apex, NC 27502-3957

Phone

(919) 434-6398

Fax

(919) 557-2089

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stonebridge Counseling PLLC

  • Mental Health Counselor
  • Apex, NC
  • NPI 1023378254
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1942416912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PEMBERTON HILL RD #103",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023957",
            "telephone_number": "919-434-6398",
            "fax_number": "919-557-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PEMBERTON HILL RD STE 103",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023957",
            "telephone_number": "919-434-6398",
            "fax_number": "919-557-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBAU",
        "first_name": "KYLE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7714",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "3335",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S7714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Stanley Kitzmiller III, DDS
• Miles Kliewer, ATC, LAT
• Haley Klink
• Alicia Kollmar
• Gordon Gary Koltis, M.D.
• Zarna Kothari
• Vera Kotlyar, RD
• Erin Dulany Kovarik, DPT
• Sydney Kranz, LMBT
• Lisa Krawiecki, CERTIFIED NURSE ASST

• Mental Health Counselor in Apex, NC
• Providers in Apex, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.