Provider Demographics
NPI:1689194987
Name:MCKENA TICHENOR, LLC
Entity type:Organization
Organization Name:MCKENA TICHENOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MCKENA
Authorized Official - Middle Name:
Authorized Official - Last Name:TICHENOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:270-295-6450
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:LEWISPORT
Mailing Address - State:KY
Mailing Address - Zip Code:42351-0297
Mailing Address - Country:US
Mailing Address - Phone:270-302-5463
Mailing Address - Fax:
Practice Address - Street 1:1210 4TH STREET
Practice Address - Street 2:
Practice Address - City:LEWISPORT
Practice Address - State:KY
Practice Address - Zip Code:42351-2526
Practice Address - Country:US
Practice Address - Phone:270-302-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173598101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty