Kiante McKinley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105308 Issued in CA

Practice address

172 Goldenrod Ave
Perris, CA 92570-7239

Phone

(310) 926-6495

NPI assigned

Sep 5, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Los Angeles Centers for Alcohol and Drug Abuse

  dba Allen House

  • Substance Abuse Rehabilitation Facility
  • Santa Fe Springs, CA
  • NPI 1922467265
  NPD (past)

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1548819246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10425 PAINTER AVE",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703429",
            "telephone_number": "562-906-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 GOLDENROD AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925707239",
            "telephone_number": "310-926-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "KIANTE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "105308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura McDowell
• Adryona McFarlin I
• Derriea McGlothern
• Beverly Ann McKeddie, LMFT
• Katy McKee
• Shawne McKnight
• Thomas McKnight, LMFT
• Desiree McLaughlin, LMFT 105097
• Lisa McMoran, ASW77052
• Christine M McNees-Kelly, CATC

• Clinical Social Worker in Perris, CA
• Providers in Perris, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.