Individual
KATHLEEN MICHELE KEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-S, NCC
Contact information
Practice address
12274B ASHLEY DR, GULFPORT, MS 39503-2759
(228) 452-6023
(228) 452-6024
Mailing address
12274B ASHLEY DR, GULFPORT, MS 39503-2759
(228) 452-6023
(228) 452-6024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2096
MS
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02204274
—
MS
Enumeration date
08/13/2013
Last updated
04/07/2021
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