Healthcare Provider Details

I. General information

NPI: 1902238561
Provider Name (Legal Business Name): CAELIN HANNA KENNEDY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN E SLEVIN LPC

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 COBBLESTONE CT STE B
MADISON MS
39110-7790
US

IV. Provider business mailing address

1596 S US 93
ELY NV
89301-9629
US

V. Phone/Fax

Practice location:
  • Phone: 601-397-4273
  • Fax:
Mailing address:
  • Phone: 601-397-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP6452-R
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1716
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: