Provider Demographics
NPI:1851621551
Name:MCKENNA, DANIEL PATRICK (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PATRICK
Last Name:MCKENNA
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 E ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6338
Mailing Address - Country:US
Mailing Address - Phone:303-748-7199
Mailing Address - Fax:
Practice Address - Street 1:1236 E ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6338
Practice Address - Country:US
Practice Address - Phone:303-748-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional