Provider Demographics
NPI:1801414636
Name:GETZ, KYLIE NICOLE
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:NICOLE
Last Name:GETZ
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 1:4404 SPRENKLE LN APT B
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-3583
Mailing Address - Country:US
Mailing Address - Phone:937-206-8038
Mailing Address - Fax:
Practice Address - Street 1:4404 SPRENKLE LN APT B
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-3583
Practice Address - Country:US
Practice Address - Phone:937-206-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701015027101YM0800X
OHE.2404100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health