Healthcare Provider Details

I. General information

NPI: 1467327098
Provider Name (Legal Business Name): KALEY CHRISTINA MACLEOD LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4576 W WALTON BLVD
WATERFORD MI
48329-4905
US

IV. Provider business mailing address

4576 W WALTON BLVD
WATERFORD MI
48329-4905
US

V. Phone/Fax

Practice location:
  • Phone: 248-618-3920
  • Fax: 248-497-5599
Mailing address:
  • Phone: 248-618-3920
  • Fax: 248-479-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024573
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: