Provider Demographics
NPI:1912793795
Name:MCKENNA, DENA (LCSW)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:MCKENNA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 79TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4039
Mailing Address - Country:US
Mailing Address - Phone:727-644-5541
Mailing Address - Fax:727-644-5541
Practice Address - Street 1:1560 79TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4039
Practice Address - Country:US
Practice Address - Phone:727-644-5541
Practice Address - Fax:727-644-5541
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW171011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical