Healthcare Provider Details

I. General information

NPI: 1285427591
Provider Name (Legal Business Name): KYLEE KILLIAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 HABERSHAM ST STE C
SAVANNAH GA
31401-9360
US

IV. Provider business mailing address

2431 HABERSHAM ST STE C
SAVANNAH GA
31401-9360
US

V. Phone/Fax

Practice location:
  • Phone: 912-713-7974
  • Fax: 912-205-5844
Mailing address:
  • Phone: 912-713-7974
  • Fax: 912-205-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSW012145
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14278018-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: