Provider Demographics
NPI:1003308727
Name:MCKINLEY, STEPHANIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 SHERANDO CIR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4003
Mailing Address - Country:US
Mailing Address - Phone:561-441-0900
Mailing Address - Fax:
Practice Address - Street 1:817 CEDAR CREEK GRADE STE 202
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6460
Practice Address - Country:US
Practice Address - Phone:561-441-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW94061041C0700X
VA09040100821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical