Active NPI
Theresa Marie McKinley, LCSW
- Clinical Social Worker
- San Bernardino, CA
National Provider Identifier
1306993712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS14050
- Practice address
- 572 N Arrowhead Ave
San Bernardino, CA 92401-1251 - Phone
- (909) 781-8027
- NPI assigned
- Jan 5, 2007
- Last updated
- Mar 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS14050 | CA | Primary |
Addresses
Primary practice location
572 N Arrowhead Ave
San Bernardino, CA 92401-1251
Mailing address
555 Technology Court
Riverside, CA 92507
Phone (951) 536-3352
Other practice location 1
555 Technology Court
Riverside, CA 92507
Phone (951) 536-3352
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | theresa.mckinley@upliftfs.org | Direct | Pacific Clinics |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS14050 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647129600000",
"number": "1306993712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 TECHNOLOGY COURT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92507",
"telephone_number": "951-536-3352",
"fax_number": "626-960-9125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 N ARROWHEAD AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011251",
"telephone_number": "909-781-8027"
}
],
"practiceLocations": [
{
"address_1": "555 Technology Court",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "92507",
"country_code": "US",
"telephone_number": "951-536-3352",
"fax_number": "626-960-9125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKINLEY",
"first_name": "THERESA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2022-03-13",
"certification_date": "2022-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS14050",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "theresa.mckinley@upliftfs.org",
"affiliation": "Y",
"endpointDescription": "business email",
"affiliationName": "Pacific Clinics",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "572 N Arrowhead Ave",
"city": "San Bernardino",
"state": "CA",
"country_code": "US",
"postal_code": "924011251",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.