Individual
MS. PAMELA JEAN MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LMFT
Contact information
Practice address
118 N SALLY DR, WINAMAC, IN 46996-9100
(574) 946-4233
(574) 946-4365
Mailing address
800 FULTON ST, ATTN: ANNE LAWSON, LOGANSPORT, IN 46947-1577
(574) 205-2600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001702A
IN
106H00000X
Marriage & Family Therapist
35001175A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184325
ANTHEM
IN
Enumeration date
07/06/2006
Last updated
03/28/2019
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