Mandy Jo McKee, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008724 Issued in IL

Practice address

1301 E Walnut St
Carbondale, IL 62901-5004

Phone

(618) 457-3371

NPI assigned

Nov 13, 2017

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 names 1

• Mandy Jo Carroll Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Shawnee Health Service and Development Corp

  • Community/Retail Pharmacy
  • Carbondale, IL
  • NPI 1760253447
  NPD (past)

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1255844296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E WALNUT ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015004",
            "telephone_number": "618-457-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E WALNUT ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015004",
            "telephone_number": "618-457-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "MANDY",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "CARROLL",
            "middle_name": "JO",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian George McElheny, M.D.
• Molly B McElvain, LCPC
• Leslie Ann McGee
• Shauna Lee Thomason McGuire, PHARMD
• Whitney McGuire, NP
• Marissa McKee, MRC, CRC, LPC, CRADC
• Zachary H McKenty, PHYSICIAN ASSISTANT
• Tyler Patrick McKibben, MD
• Deedra Gail McLain, M.D.
• Jonnah Shayne McManus, MD

• Clinical Social Worker in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.