Provider Demographics
NPI:1205271293
Name:MCGIRT, KESHIA SHULUNDA (MS, ALC)
Entity type:Individual
Prefix:
First Name:KESHIA
Middle Name:SHULUNDA
Last Name:MCGIRT
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:GROVE HILL
Mailing Address - State:AL
Mailing Address - Zip Code:36451-0248
Mailing Address - Country:US
Mailing Address - Phone:251-275-4135
Mailing Address - Fax:251-275-2862
Practice Address - Street 1:300 CARTER DR
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-3306
Practice Address - Country:US
Practice Address - Phone:251-275-4135
Practice Address - Fax:251-275-2862
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2105A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health