Provider Demographics
NPI:1336947282
Name:MCKINNEY, WHITNEY DIANE (LMSW)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:DIANE
Last Name:MCKINNEY
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 NELAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-1441
Mailing Address - Country:US
Mailing Address - Phone:616-690-1364
Mailing Address - Fax:
Practice Address - Street 1:1239 76TH ST SW STE H4
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-7921
Practice Address - Country:US
Practice Address - Phone:616-258-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker