Provider Demographics
NPI:1326807181
Name:KITTLER, SHAMICHAEL MALAKEIA SHANELLE (LPC)
Entity Type:Individual
Prefix:
First Name:SHAMICHAEL
Middle Name:MALAKEIA SHANELLE
Last Name:KITTLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 DARTMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-4348
Mailing Address - Country:US
Mailing Address - Phone:251-605-4586
Mailing Address - Fax:
Practice Address - Street 1:1501 DECATUR HWY
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-3857
Practice Address - Country:US
Practice Address - Phone:205-644-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4609101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health