Provider Demographics
NPI:1508620139
Name:MCKEIRNAN, MADISON (MSW)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:MCKEIRNAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 E LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3868
Mailing Address - Country:US
Mailing Address - Phone:814-215-1050
Mailing Address - Fax:
Practice Address - Street 1:6065 ROSWELL RD STE 960
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4038
Practice Address - Country:US
Practice Address - Phone:404-919-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker