Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1487133609 Individual Practitioner Male Practitioner

Kyle Blaylock , ACSW

Counselor • Eureka, CA

Professional Overview & Biography Verified Profile Summary

Kyle Blaylock, ACSW is a registered healthcare professional specializing in Counselor in Eureka, CA. Practice services are available at 2259 MYRTLE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2259 Myrtle Ave

Eureka, CA 955013325

Telephone 7074448293
Fax 7074448298
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Eureka, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.0 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
99 Specialists

Practicing in Eureka, CA (14303 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-11-14
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License CA 100601

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.

Secondary Practice Locations

3960 Walnut Dr

Eureka, CA 95503

Phone: 7072688722

720 Wood St

Eureka, CA 955014413

Phone: 5306938040

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Ravenna Giannotta

Rehabilitation Practitioner

NPI 1003686692
Molly Wroten

Case Manager/Care Coordinator

NPI 1023532900
Barnabas Keister , BACHELORS DEGREE

Rehabilitation Practitioner

NPI 1033392238

BACHELORSDEGREE

Samantha Williams-Gray , BA

Case Manager/Care Coordinator

NPI 1043512262

Bachelor of Arts

NPI 1043650674

Associate Social Worker

Desirae Witzke

Case Manager/Care Coordinator

NPI 1053887125

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2022

Counselor (License #100601 in CA)

📍
Updated Practice Location October 28, 2022

Registered at 2259 MYRTLE AVE, EUREKA, CA 955013325 (Tel: 7074448293)

📍
Updated Business Mailing Address October 28, 2022

Registered at 2259 MYRTLE AVE, EUREKA, CA 955013325 (Tel: 7074448293)

👤
Provider Name / Credentials Updated October 28, 2022

Recorded as KYLE BLAYLOCK, ACSW

📍
Updated Practice Location November 27, 2019

Registered at 3960 WALNUT DR, EUREKA, CA 95503 (Tel: 7072688722)

📍
Updated Business Mailing Address November 27, 2019

Registered at 3960 WALNUT DR, EUREKA, CA 955038938 (Tel: 7072688722)

NPI Profile Active August 08, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location August 08, 2018

Registered at 720 WOOD ST, EUREKA, CA 955014413 (Tel: 5306938040)

📍
Updated Business Mailing Address August 08, 2018

Registered at 720 WOOD ST, EUREKA, CA 955014413 (Tel: 5306938040)

👤
Provider Name / Credentials Updated August 08, 2018

Recorded as KYLE BLAYLOCK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2018

Case Manager/Care Coordinator

🟢
Initial NPI Registration & Enumeration August 08, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487133609
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 08, 2018
Last Update: November 14, 2022
Sole Proprietor: No

Mailing Address

2259 Myrtle Ave

Eureka, CA 955013325

Phone: 7074448293

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.