Provider Demographics
NPI:1669485629
Name:MCKINNEY, SHERRY (PHD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 MO PAC CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6807
Mailing Address - Country:US
Mailing Address - Phone:512-327-4968
Mailing Address - Fax:512-327-4988
Practice Address - Street 1:1007 MO PAC CIR STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6807
Practice Address - Country:US
Practice Address - Phone:512-327-4968
Practice Address - Fax:512-327-4988
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31247103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1392Medicare PIN