Provider Demographics
NPI:1225456007
Name:MCKINNEY, JOHN A (LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5911
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-5911
Mailing Address - Country:US
Mailing Address - Phone:865-214-7017
Mailing Address - Fax:
Practice Address - Street 1:100 BRIARWOOD DR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-4201
Practice Address - Country:US
Practice Address - Phone:865-313-5462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MEMC218391041C0700X
TN133141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker