MEDICARE: MIKAELA MCKEE COUNSELING, LLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1558932160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIKAELA MCKEE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	4535 SOUTHWESTERN BLVD STE 206A
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-1861
Country	:	US
Telephone Number	:	716-361-1463
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 W 21ST ST STE 29
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16506-2972
Country	:	US
Telephone Number	:	716-361-1463
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MIKAELA MCKEE
Credential	:	LCSW
Telephone Number	:	716-361-1463

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	03/10/2023

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