Provider Demographics
NPI:1609350040
Name:MCKINNEY, JOANN J (CLINICAL SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:J
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-5920
Mailing Address - Country:US
Mailing Address - Phone:954-303-7737
Mailing Address - Fax:
Practice Address - Street 1:6133 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-5920
Practice Address - Country:US
Practice Address - Phone:954-303-7737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW129651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical