Provider Demographics
NPI:1265771216
Name:MCKINLEY, ERIN E (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:MCKINLEY
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 1:225 5TH AVE NE
Mailing Address - Street 2:APT. #34
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2656
Mailing Address - Country:US
Mailing Address - Phone:813-419-7453
Mailing Address - Fax:
Practice Address - Street 1:225 5TH AVE NE
Practice Address - Street 2:APT. #34
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2656
Practice Address - Country:US
Practice Address - Phone:813-419-7453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLISW6999104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator