Provider Demographics
NPI:1407696925
Name:PHILLIPS, KEESHUNDA ANDRIEKA (LCMHCA)
Entity type:Individual
Prefix:
First Name:KEESHUNDA
Middle Name:ANDRIEKA
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:LCMHCA
Other - Prefix:
Other - First Name:KEESHUNDA
Other - Middle Name:ANDRIEKA
Other - Last Name:POSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:2208 B BROOKVILLE DR GREENVILLE, NC 27834
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27534
Mailing Address - Country:US
Mailing Address - Phone:704-692-4088
Mailing Address - Fax:
Practice Address - Street 1:231 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5029
Practice Address - Country:US
Practice Address - Phone:252-321-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health