Provider Demographics
NPI:1679316467
Name:MCKINNEY, MEG
Entity type:Individual
Prefix:
First Name:MEG
Middle Name:
Last Name:MCKINNEY
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 1:6822 NE BERGMAN RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1285
Mailing Address - Country:US
Mailing Address - Phone:907-255-6342
Mailing Address - Fax:
Practice Address - Street 1:6822 NE BERGMAN RD
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1285
Practice Address - Country:US
Practice Address - Phone:907-255-6342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61581903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health