Provider Demographics
NPI:1063762532
Name:MCKINNEY, JUDITH JENNIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:JENNIE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N CENTER DR
Mailing Address - Street 2:BUILDING 11, SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4007
Mailing Address - Country:US
Mailing Address - Phone:757-961-3255
Mailing Address - Fax:757-961-3265
Practice Address - Street 1:420 N CENTER DR
Practice Address - Street 2:BUILDING 11, SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4007
Practice Address - Country:US
Practice Address - Phone:757-961-3255
Practice Address - Fax:757-961-3265
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002006101YP2500X
VA0717000595106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional