Active NPI
William McKenna, PSY.D.
- Clinical Psychologist
- Richmond, VA
National Provider Identifier
1336635002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810006009
- Practice address
- 5821 Staples Mill Rd
Richmond, VA 23228-5427 - Phone
- (804) 264-0966
- Fax
- (804) 264-1029
- NPI assigned
- Jul 6, 2018
- Sex
- Male
- Sole proprietor
- No
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 Psychologist | 103TC0700X | 0810006009 | VA | Primary |
Addresses
Primary practice location
5821 Staples Mill Rd
Richmond, VA 23228-5427
Mailing address
5821 Staples Mill Rd
Richmond, VA 23228-5427
Phone (804) 264-0966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810006009 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1336635002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5821 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232285427",
"telephone_number": "804-264-0966",
"fax_number": "804-264-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5821 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232285427",
"telephone_number": "804-264-0966",
"fax_number": "804-264-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-06",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810006009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.