MS. KISHA WYNNETTE MICKENS (LPC) – Professional Counselor, NPI 1447933973

MS. KISHA WYNNETTE MICKENS (LPC) is a healthcare provider. based in West point, Virginia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 0701012722 (VA). The NPI Number for MS. KISHA WYNNETTE MICKENS (LPC) is 1447933973

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
MS. KISHA WYNNETTE MICKENS (LPC)
NPI
1447933973
Phone
(804) 767-0973
Address
3210 MATTAPONI AVE
Enumeration Date
10 August 2023
Last Update Date
10 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7572203200
Graduation Year
2006 (20 years ago)
PAC ID
9133579014
Group Practice PAC ID
7012010549
Professional Enrollment ID
I20231219003047
Address ID
VA231855624WI1657XTRLX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,998 MENTAL HEALTH COUNSELOR in VA

Provider Addresses for MS. KISHA WYNNETTE MICKENS (LPC)

  • 3210 MATTAPONI AVE

    WEST POINT, VA 231819307

    Phone: (804) 767-0973

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231219003047IMental Health CounselorVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23181)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012010549View full group profile
NameSpecialtyState
Mental Health CounselorVA
P S Y C H I A T R YVA
-VA
-VA
Mental Health CounselorVA
-VA
Clinical Social WorkerVA
Clinical Social WorkerVA
P S Y C H I A T R YVA
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Can I verify MS. KISHA WYNNETTE MICKENS (LPC) with an NPI only?
You can start verification with NPI 1447933973 for MS. KISHA WYNNETTE MICKENS (LPC), then check state licensing separately.
Does the file indicate MS. KISHA WYNNETTE MICKENS (LPC) is practicing under active NPI?
Directory data currently reports MS. KISHA WYNNETTE MICKENS (LPC) as active.
What taxonomy line describes MS. KISHA WYNNETTE MICKENS (LPC)?
For research purposes, treat MS. KISHA WYNNETTE MICKENS (LPC) as Professional Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MS. KISHA WYNNETTE MICKENS (LPC)?
MS. KISHA WYNNETTE MICKENS (LPC)'s geographic hint is West Point, Virginia in our summary view.
Is the information about MS. KISHA WYNNETTE MICKENS (LPC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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