Sandra Mary McKinney, LCSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000232A Issued in IN

Practice address

550 S Adams St
Bloomington, IN 47403-2165

Phone

(812) 333-6324

Fax

(812) 331-6700

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2020 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Service of Bartholomew County, Inc.

  • Clinical Psychologist
  • Columbus, IN
  • NPI 1922141290
  NPD (past)
• New Outlook Counseling Center Inc

  • Community/Behavioral Health Agency
  • Bloomington, IN
  • NPI 1033527619
  NPD (past)
• New Outlook Counseling Center Inc

  • Community/Behavioral Health Agency
  • Bloomington, IN
  • NPI 1891099073
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1043353402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032165",
            "telephone_number": "812-333-6324",
            "fax_number": "812-331-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032165",
            "telephone_number": "812-333-6324",
            "fax_number": "812-331-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "SANDRA",
        "middle_name": "MARY",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000232A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "487861",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO PROVIDER NUMBER",
            "identifier": "069913",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles R. McKeen III, MD
• Amanda F McKenzie, M.A.
• Kayla K McKibben
• Elisa McKinley
• Lee McKinley, MD
• Elizabeth McKnight, RN
• Kyle McLain, LMHC
• Ana Maria McLamb, MA, ATR, LMHC
• Lisa Ann McMichael, PSY.D
• Deborah Ann McMillian, MSW, LCSW

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.