McKenna Counseling LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

MCKENNA COUNSELING LLC

Practice address

3526 N California Ave Ste 101
Peoria, IL 61603-1143

Phone

(309) 431-1297

NPI assigned

Feb 13, 2020

Organization subpart

No

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

Authorized official

Name

Kelly McKenna, LCSWNPI 1982723250

Title

Owner

Phone

(309) 431-1297

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly McKenna, LCSW

  • Mental Health Counselor
  • Danville, IL
  • NPI 1982723250
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1700419223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14107 N WAYNE RD",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615239154",
            "telephone_number": "217-377-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 N CALIFORNIA AVE STE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031143",
            "telephone_number": "309-431-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENNA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-431-1297",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL",
            "identifier": "149013193",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany McIntyre
• Samuel Brian McIntyre, ED.D
• Seth McIntyre, PHARMD
• Josephine Kay McKean, DO
• Karen M McKean, PTA
• Deborah J. McKenna, LCPC
• Emily McKenna
• Duane McKillip, LCSW
• Richard Hugh McKone, DDS
• Heather McLauchlan, MD

• Point of Service in Peoria, IL
• Providers in Peoria, IL by specialty
• Point of Service in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.