Provider Demographics
NPI:1285036368
Name:MCKENNEY, BONNIE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:MCKENNEY
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5262 OLYMPIC DR NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1795
Mailing Address - Country:US
Mailing Address - Phone:253-691-5900
Mailing Address - Fax:253-358-3630
Practice Address - Street 1:5262 OLYMPIC DR NW
Practice Address - Street 2:SUITE A
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1795
Practice Address - Country:US
Practice Address - Phone:253-691-5900
Practice Address - Fax:253-358-3630
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-20
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60665876101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health