Provider Demographics
NPI:1639639966
Name:MCKEE ROBERTS, KAETLYN (LPC)
Entity Type:Individual
Prefix:
First Name:KAETLYN
Middle Name:
Last Name:MCKEE ROBERTS
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 1:324 COMANCHE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-9319
Mailing Address - Country:US
Mailing Address - Phone:573-723-1219
Mailing Address - Fax:573-562-6121
Practice Address - Street 1:754 BAGNELL DAM BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-8703
Practice Address - Country:US
Practice Address - Phone:573-723-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019009397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional