Provider Demographics
NPI:1326419755
Name:KITCHEN, MICHELLE MARIA (PHD, NCC, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIA
Last Name:KITCHEN
Suffix:
Gender:F
Credentials:PHD, NCC, LPC
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 433
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-0433
Mailing Address - Country:US
Mailing Address - Phone:843-991-7409
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN ST STE D2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2665
Practice Address - Country:US
Practice Address - Phone:843-991-7409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional