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Individual

CAROL A MCKENNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
140 WOOD RD, STE 101, BRAINTREE, MA 02184-2512
(617) 407-4705
(617) 607-7567
Mailing address
140 WOOD RD STE 305, BRAINTREE, MA 02184-2514
(617) 407-4705
(617) 607-7567

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7479
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110093018A
MA
01
138881
VALUE OPTIONS
MA
01
21482
BEACON HEALTH
MA
01
828377534
OPTUM
MA
01
8329-01
HARVARD PILGRIM HEALTH
MA
01
V22582
NETWORK HEALTH
MA
01
W05840
BLUE CROSS BLUE SHEILD OF MASS
MA
Enumeration date
01/21/2008
Last updated
04/12/2018
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