Provider Demographics
NPI:1841403524
Name:MCKENNA, SHERRI SUE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:SUE
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 FALLSMEAD WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-5549
Mailing Address - Country:US
Mailing Address - Phone:301-424-2328
Mailing Address - Fax:
Practice Address - Street 1:1620 ELTON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1740
Practice Address - Country:US
Practice Address - Phone:301-439-7191
Practice Address - Fax:301-439-1169
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG10943104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker