Individual
CAROL A MCKENNA
Active
Individual
CAROL A MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
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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