Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kyle David Raque, PSYD

Individual provider Clinical Psychologist · NPI 1790863900

Dr. Kyle David Raque, PSYD is a Clinical Psychologist in Blue Ridge, Georgia. Qualified in 2005, 21 years ago. Practices with Blue Ridge Psychological Services, LLC, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
21
Licensed in
GA
In the registry since
2006
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

9757 Blue Ridge Dr
Blue Ridge, GA 30513-4167
Phone: (706) 455-2490
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY003039 (GA)

Record details

NPI number1790863900
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedNovember 2, 2006
Last updated in NPPESFebruary 26, 2020
Certification dateFebruary 26, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Blue Ridge Psychological Services, Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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