Provider Demographics
NPI:1902669740
Name:KYLEY J. TRAUSCH, LCSW LLC
Entity Type:Organization
Organization Name:KYLEY J. TRAUSCH, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KYLEY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:TRAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-502-8185
Mailing Address - Street 1:6299 N EAGLE RD # 1005
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-0955
Mailing Address - Country:US
Mailing Address - Phone:208-502-8185
Mailing Address - Fax:208-900-1698
Practice Address - Street 1:13447 W WALDEMAR ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0843
Practice Address - Country:US
Practice Address - Phone:208-502-8185
Practice Address - Fax:208-900-1698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty