Provider Demographics
NPI:1568884757
Name:MULLINS, KAILEY (LCSW)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5131
Mailing Address - Country:US
Mailing Address - Phone:847-360-1020
Mailing Address - Fax:847-360-1065
Practice Address - Street 1:1130 S CANAL ST # 1683
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4907
Practice Address - Country:US
Practice Address - Phone:312-847-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor