Provider Demographics
NPI:1669641148
Name:JOYCE M. MCKENNA LMSW, ACSW, PLLC
Entity Type:Organization
Organization Name:JOYCE M. MCKENNA LMSW, ACSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW,ACSW
Authorized Official - Phone:517-324-5426
Mailing Address - Street 1:5000 NORTHWIND DR
Mailing Address - Street 2:SUITE 222
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5044
Mailing Address - Country:US
Mailing Address - Phone:517-324-5426
Mailing Address - Fax:517-324-5426
Practice Address - Street 1:5000 NORTHWIND DR
Practice Address - Street 2:SUITE 222
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5044
Practice Address - Country:US
Practice Address - Phone:517-324-5426
Practice Address - Fax:517-324-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010644051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty