Provider Demographics
NPI:1447095708
Name:OVERBEY, KYLIE ANGELA
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:ANGELA
Last Name:OVERBEY
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 1:408 E BOLTON ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-5920
Mailing Address - Country:US
Mailing Address - Phone:940-500-7082
Mailing Address - Fax:
Practice Address - Street 1:408 E BOLTON ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-5920
Practice Address - Country:US
Practice Address - Phone:940-500-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95643101YM0800X
GAAPC010213101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health