Provider Demographics
NPI:1174392914
Name:MULLINS, KAYCEE LASHAE (MSCJA)
Entity type:Individual
Prefix:MRS
First Name:KAYCEE
Middle Name:LASHAE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:MSCJA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1709
Mailing Address - Country:US
Mailing Address - Phone:304-859-0726
Mailing Address - Fax:
Practice Address - Street 1:2157 GREENBRIER ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-9623
Practice Address - Country:US
Practice Address - Phone:304-344-5924
Practice Address - Fax:304-344-3503
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)