Provider Demographics
NPI:1598598419
Name:MAYFIELD, KAHLEY LOVE
Entity type:Individual
Prefix:
First Name:KAHLEY
Middle Name:LOVE
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAXIMO
Other - Middle Name:LEONARDO
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:206 CLARENCE ST
Mailing Address - Street 2:
Mailing Address - City:YALE
Mailing Address - State:MI
Mailing Address - Zip Code:48097-2909
Mailing Address - Country:US
Mailing Address - Phone:517-599-8950
Mailing Address - Fax:
Practice Address - Street 1:8032 LAKESHORE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MI
Practice Address - Zip Code:48450-9719
Practice Address - Country:US
Practice Address - Phone:810-201-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker