Provider Demographics
NPI:1376248070
Name:MCKINLEY, LORI ANN (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18014 TRANQUILITY RD
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-9031
Mailing Address - Country:US
Mailing Address - Phone:540-450-6430
Mailing Address - Fax:
Practice Address - Street 1:18014 TRANQUILITY RD
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-9031
Practice Address - Country:US
Practice Address - Phone:540-450-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional