KYLE BLAYLOCK ACSW
NPI 1487133609
Counselor in Eureka, CA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

Active since August 08, 2018

2259 MYRTLE AVE, EUREKA, CA 95501(707) 444-8293(707) 444-8298 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 14, 2022, Oct 28, 2022, Nov 27, 2019 and 1 more (4 updates tracked since 2018).

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About Kyle Blaylock Acsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE BLAYLOCK ACSW (NPI 1487133609) is an individual counselor in Eureka, California, licensed in California (100601) and active in the NPI registry since August 2018. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1487133609

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameKYLE BLAYLOCKCredential: ACSW

Location Address2259 MYRTLE AVEEureka, CA 95501-3325

Mailing Address2259 Myrtle AveEureka, CA 95501-3325 · (707) 444-8293 · Fax (707) 444-8298

Phone(707) 444-8293

Fax(707) 444-8298

Sole ProprietorNo

Enumeration DateAugust 8, 2018

Last NPPES UpdateNovember 14, 20224 updates tracked since enumeration

NPPES CertifiedNovember 14, 2022

✔ NPI 1487133609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in CA · 100601

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2259 MYRTLE AVE, Eureka, CA 95501

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