Organization
MCKENNA COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MCKENNA LCSW (OWNER)
(309) 431-1297
Entity
Organization
Contact information
Practice address
3526 N CALIFORNIA AVE STE 101, PEORIA, IL 61603-1143
(309) 431-1297
Mailing address
14107 N WAYNE RD, CHILLICOTHE, IL 61523-9154
(217) 377-1600
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149013193
STATE OF IL
IL
Enumeration date
02/13/2020
Last updated
02/13/2020
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