Provider Demographics
NPI:1508672049
Name:FOLUKE MCKANNEY, AYANA (LCSW)
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:FOLUKE MCKANNEY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:AYANA
Other - Middle Name:
Other - Last Name:MCKANNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:519 W 22ND ST
Mailing Address - Street 2:SUITE 100 #93052
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:917-923-3699
Mailing Address - Fax:
Practice Address - Street 1:519 W 22ND ST
Practice Address - Street 2:SUITE 100 #93052
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:917-923-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW043171041C0700X
NJ44SL067395001041C0700X
NY15321242111041S0200X
NY0989401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW04317OtherLICENSE
NJ44SL06739500OtherLICENSE