Provider Demographics
NPI:1417483546
Name:MCKENNA, JOAN MARIE (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24110 CHERRY HILL ROAD
Mailing Address - Street 2:PASTORAL COUNSELING AND CONSULTATION SERVICES
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1356
Mailing Address - Country:US
Mailing Address - Phone:313-274-4570
Mailing Address - Fax:313-274-4571
Practice Address - Street 1:24110 CHERRY HILL ROAD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1356
Practice Address - Country:US
Practice Address - Phone:313-274-4570
Practice Address - Fax:313-274-4571
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical