Provider Demographics
NPI:1497861264
Name:MCKINNEY, WILLIAM I (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:I
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 822
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-0822
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-731-7165
Practice Address - Street 1:1 FREEDOM WAY # 293
Practice Address - Street 2:ALLIED HEALTH SERVICE LINE
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-731-7165
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0008081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical