Individual provider Active NPI

Jackie Lynn McKenney, LPC

  • Professional Counselor
  • Frisco, CO
National Provider Identifier
1285024059
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3877 Issued in CO
Practice address
360 Peak One Drive
Ste 110
Frisco, CO 80443
Phone
(970) 668-3478
Fax
(970) 668-0632
NPI assigned
Jan 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3877 CO Primary

Addresses

Primary practice location

360 Peak One Drive
Ste 110
Frisco, CO 80443

Mailing address

715 Horizon Dr
Ste 225
Grand Junction, CO 81506-8700
Phone (970) 683-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3877COMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1285024059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HORIZON DR",
            "address_2": "STE 225",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068700",
            "telephone_number": "970-683-7107",
            "fax_number": "970-683-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DRIVE",
            "address_2": "STE 110",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-3478",
            "fax_number": "970-668-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNEY",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "3877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.