MS. KATHLEEN MARY MCKENNA (NPI# 1720282130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720282130 |
| Entity Type | Individual |
| Full Name | MS. KATHLEEN MARY MCKENNA |
| Credential | LICSW |
| Practice Address |
225 Liberty St Brockton MA 02301-5571 |
| Mailing Address |
64 Ashley Ln Middleboro MA 02346-3200 |
| Practice Telephone | 5084270246 |
| Practice Fax Number | 5084270244 |
| Mailing Telephone | 5089463478 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1575 | MA | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
ISW01678 | RI | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
1028748 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639498546 | Kathleen Mckenna | Counselor | 5046 Clayton Ave, Pennsauken, NJ 08109-1910 | 2010-05-18 |
| 1487199709 | Kathleen E. Mckenna | Nurse Practitioner | 210 W Saint Georges Ave Fl 2, Linden, NJ 07036-3990 | 2016-12-21 |
| 1366994816 | Kathleen L. Mckenna | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2016-11-01 |
| 1003250176 | Kathleen Mckenna | Family Medicine | 849 Pacific Ave, Hood River, OR 97031-1956 | 2013-04-19 |
| 1558689406 | Kathleen Mckenna | Registered Nurse | 2023 Vale Rd, San Pablo, CA 94806-3834 | 2010-05-16 |
| 1932357068 | Kathleen M Mckenna | Physical Therapist | 1300 Post Rd, Suite 204, Fairfield, CT 06824-6038 | 2008-09-03 |
| 1487722724 | Kathleen Elizabeth Mckenna | Counselor | 1670-78 East 17th Street, Brooklyn, NY 11229 | 2006-12-04 |
| 1265503908 | Kathleen M. Mckenna | Psychiatry & Neurology | 2300 N Childrens Plz # 10, Chicago, IL 60614-3363 | 2006-11-13 |
| 1699711358 | Kathleen Moira Mckenna | Radiology | 100 S San Mateo Dr, San Mateo, CA 94401-3805 | 2006-06-21 |
| Street Address |
225 LIBERTY ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-5571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1720540156 | Nicilda Dejesus | Counselor | 204 Chatham West Dr, Brockton, MA 02301-1314 | 2019-04-04 |
| 1285160838 | Maria Atherton Jr. | Counselor | 17 Snell St, Brockton, MA 02301-1644 | 2017-05-02 |
| 1467726398 | Carin Rhodes | Counselor | 1115 W Chestnut St Ste 101, Brockton, MA 02301-7501 | 2012-02-23 |
| 1073817573 | Daniel Mendes Depina | Counselor | 682 North Main Street, Apt. 308, Brockton, MA 02301-3626 | 2010-12-27 |
| 1063713402 | Judith R Chaskes | Counselor | 30 Meadowbrook Road, Brockton, MA 02301 | 2010-11-16 |
| 1093957185 | Jerome P Posey | Counselor | 1311 Main St, Brockton, MA 02301-7109 | 2009-04-03 |
| 1548441587 | Sylvester Pereira Fortes | Counselor | 20 Hope St, Brockton, MA 02302-3415 | 2007-11-19 |
| 1184817579 | George Hamilton Brickhouse Jr. | Counselor | 108 Centre Street, Brockton, MA 02302 | 2007-08-20 |
| 1174725378 | Cynthia Wigfall | Counselor | 280 North Warren Ave. A 6, Brockton, MA 02301 | 2007-06-01 |
| Find all providers in BROCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.