Provider Demographics
NPI:1770348625
Name:MCCAFFREY, KIRSTEN KAY (LLPC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:KAY
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21197 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1811
Mailing Address - Country:US
Mailing Address - Phone:616-214-9927
Mailing Address - Fax:
Practice Address - Street 1:32901 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4063
Practice Address - Country:US
Practice Address - Phone:586-646-0667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health