Provider Demographics
NPI:1598437816
Name:MCKINNEY, CAROL ELAYNE (LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ELAYNE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5184 DREW DR
Mailing Address - Street 2:
Mailing Address - City:MULGA
Mailing Address - State:AL
Mailing Address - Zip Code:35118-9250
Mailing Address - Country:US
Mailing Address - Phone:205-602-5072
Mailing Address - Fax:205-379-2495
Practice Address - Street 1:2344 VALLEYDALE RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2089
Practice Address - Country:US
Practice Address - Phone:205-602-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional