Provider Demographics
NPI:1730733676
Name:EIBEL, KYLIE
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:EIBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 COAL RUN RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-9167
Mailing Address - Country:US
Mailing Address - Phone:740-297-4726
Mailing Address - Fax:404-871-4617
Practice Address - Street 1:1590 COAL RUN RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-9167
Practice Address - Country:US
Practice Address - Phone:740-297-4726
Practice Address - Fax:740-487-1461
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1903934101Y00000X, 1041C0700X
OHLCDCIII.162070101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)