Provider Demographics
NPI:1912237215
Name:MCKEEL, SANDRA L (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:MCKEEL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1448
Mailing Address - Country:US
Mailing Address - Phone:724-513-5775
Mailing Address - Fax:724-774-0380
Practice Address - Street 1:697 STATE STREET
Practice Address - Street 2:
Practice Address - City:VANPORT
Practice Address - State:PA
Practice Address - Zip Code:15009
Practice Address - Country:US
Practice Address - Phone:724-770-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional