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NPI Code Detail

MEDICARE: KEESHA MCMILLIAN LPCC-S

MEDICARE:   KEESHA  MCMILLIAN  LPCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1093124760
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEESHA MCMILLIAN LPCC-S
Provider Business Mailing Address
First Line : 5241 WILSON MILLS RD
Second Line : SUITE 24
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2150
Country : US
Telephone Number : 216-321-1539
Fax Number :
Provider Business Practice Location Address
First Line : 5241 WILSON MILLS RD
Second Line : SUITE 24
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2150
Country : US
Telephone Number : 216-321-1539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2014
Last Update Date : 08/08/2014

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Directions to “ KEESHA MCMILLIAN LPCC-S” Practice Location

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