Provider Demographics
NPI:1477257350
Name:MCKENNA, MICAELA LEIGH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:LEIGH
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9200 INDIAN CREEK PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2008
Mailing Address - Country:US
Mailing Address - Phone:913-220-2450
Mailing Address - Fax:913-220-2423
Practice Address - Street 1:9200 INDIAN CREEK PKWY STE 380
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2008
Practice Address - Country:US
Practice Address - Phone:913-220-2450
Practice Address - Fax:913-220-2423
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20190184691041C0700X
KS50601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical