Provider Demographics
NPI:1831572825
Name:PYLE, JACQUELINE (LPC, LBSW)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:
Last Name:PYLE
Suffix:
Gender:F
Credentials:LPC, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 COLUMBIA AVE E STE 4
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5468
Mailing Address - Country:US
Mailing Address - Phone:269-962-9611
Mailing Address - Fax:269-962-9612
Practice Address - Street 1:491 COLUMBIA AVE E STE 4
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5468
Practice Address - Country:US
Practice Address - Phone:269-962-9611
Practice Address - Fax:269-962-9612
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009580101YP2500X
MI6802077897104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker