Provider Demographics
NPI:1093418071
Name:BEATTIE-DEBUTTS, KACEY JEAN (MSHS, BS, CHW)
Entity Type:Individual
Prefix:
First Name:KACEY
Middle Name:JEAN
Last Name:BEATTIE-DEBUTTS
Suffix:
Gender:F
Credentials:MSHS, BS, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 E COLDWATER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-1501
Mailing Address - Country:US
Mailing Address - Phone:810-257-3740
Mailing Address - Fax:
Practice Address - Street 1:1057 E COLDWATER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-1501
Practice Address - Country:US
Practice Address - Phone:810-257-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor