Provider Demographics
NPI:1093999187
Name:MCKEEHAN, CHRISTINE LYNN (ASW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN
Last Name:MCKEEHAN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:LYNN
Other - Last Name:SOVITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95252-1838
Mailing Address - Country:US
Mailing Address - Phone:209-996-7890
Mailing Address - Fax:815-301-3600
Practice Address - Street 1:1931 N RANCHERO RD.
Practice Address - Street 2:
Practice Address - City:VALLEY SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95252
Practice Address - Country:US
Practice Address - Phone:209-231-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical