Provider Demographics
NPI:1225553431
Name:MCGEE, KANDACE
Entity type:Individual
Prefix:
First Name:KANDACE
Middle Name:
Last Name:MCGEE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 ROSSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE SANDS
Mailing Address - State:NM
Mailing Address - Zip Code:88002-1045
Mailing Address - Country:US
Mailing Address - Phone:502-883-8205
Mailing Address - Fax:
Practice Address - Street 1:4814 KINGFISHER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213
Practice Address - Country:US
Practice Address - Phone:502-999-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2025-0143104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker