Provider Demographics
NPI:1083760359
Name:MCKENNA, FRANCES NADINE (CADCI)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:NADINE
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 SUNNYVIEW RD NE
Mailing Address - Street 2:11
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-3833
Mailing Address - Country:US
Mailing Address - Phone:503-706-1659
Mailing Address - Fax:
Practice Address - Street 1:3325 HAROLD DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1339
Practice Address - Country:US
Practice Address - Phone:503-363-2021
Practice Address - Fax:503-363-4820
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06-03-29101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator