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Individual

MR. EDWARD M MCKINLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
51 PLEASANT ST, 3RD FLOOR, NEWBURYPORT, MA 01950-2637
(603) 860-4439
Mailing address
95 PARKER ST, NEWBURYPORT, MA 01950-4033
(603) 860-4439

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113951
MA
1041C0700X
Clinical Social Worker
1248
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000417901
MEDICARE PTAN
MA
Enumeration date
11/13/2007
Last updated
03/27/2017
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