1639617004 NPI number — THERESE MCKECHNIE, MSW, LSCSW, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639617004 NPI number — THERESE MCKECHNIE, MSW, LSCSW, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERESE MCKECHNIE, MSW, LSCSW, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639617004
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4809 W 117TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEAWOOD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66211-2051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-362-0315
Provider Business Mailing Address Fax Number:
913-362-0394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4809 W 117TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-2051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-362-0315
Provider Business Practice Location Address Fax Number:
913-362-0394
Provider Enumeration Date:
02/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MCKECHNIE
Authorized Official First Name:
THERESE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
913-362-0315

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  928 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com