Provider Demographics
NPI:1689364218
Name:MCKINNEY, ELAINE (LPC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:BOUSELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAPC
Mailing Address - Street 1:222 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2235
Mailing Address - Country:US
Mailing Address - Phone:484-301-0204
Mailing Address - Fax:
Practice Address - Street 1:222 WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-2235
Practice Address - Country:US
Practice Address - Phone:484-301-0204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional