Provider Demographics
NPI:1154423531
Name:MCKINNEY, BRENDA LEE (MS PCC)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LEE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MS PCC
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:L
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 840
Mailing Address - Street 2:87 STAMBAUGH AVENUE SUITE 5
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146
Mailing Address - Country:US
Mailing Address - Phone:724-982-0414
Mailing Address - Fax:724-982-4407
Practice Address - Street 1:87 STAMBAUGH AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146
Practice Address - Country:US
Practice Address - Phone:724-982-0414
Practice Address - Fax:724-982-4407
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4190101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor