Provider Demographics
NPI:1952346751
Name:MCKEEN, AGNES KATHLEEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AGNES
Middle Name:KATHLEEN
Last Name:MCKEEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:K
Other - Last Name:GLAVEN-MCKEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:600 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8643
Mailing Address - Country:US
Mailing Address - Phone:256-975-4291
Mailing Address - Fax:256-429-9411
Practice Address - Street 1:500 SHAE PARK RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3597
Practice Address - Country:US
Practice Address - Phone:256-701-5651
Practice Address - Fax:256-429-9411
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2264101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S-836OtherTHE ASSOCIATION FOR PLAY THERAPY, INC. REGISTERED PLAY THERAPIST AND SUPERVISOR
206738OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS, INC.
AL2264OtherTHE BOARD OF EXAMINERS IN COUNSELING STATE OF ALABAMA-LICENSE