Provider Demographics
NPI:1437589686
Name:MCKINNEY CARO, KERRI (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:
Last Name:MCKINNEY CARO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18444 N 25TH AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1268
Mailing Address - Country:US
Mailing Address - Phone:602-499-9952
Mailing Address - Fax:602-499-9952
Practice Address - Street 1:18444 N 25TH AVE STE 420
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1268
Practice Address - Country:US
Practice Address - Phone:602-499-9952
Practice Address - Fax:602-499-9952
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-24
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-13342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker