Provider Demographics
NPI:1205040243
Name:MCKINNEY, RAQUEL VASQUEZ (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:VASQUEZ
Last Name:MCKINNEY
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 1:2218 HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-2188
Mailing Address - Country:US
Mailing Address - Phone:973-278-5320
Mailing Address - Fax:
Practice Address - Street 1:2218 HOLLOW WAY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-2188
Practice Address - Country:US
Practice Address - Phone:973-278-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical