Provider Demographics
NPI:1346014859
Name:MCKENLY, KARLENE
Entity Type:Individual
Prefix:
First Name:KARLENE
Middle Name:
Last Name:MCKENLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14521 KENT DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-7772
Mailing Address - Country:US
Mailing Address - Phone:301-237-5013
Mailing Address - Fax:
Practice Address - Street 1:14521 KENT DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-7772
Practice Address - Country:US
Practice Address - Phone:301-237-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator