Healthcare Provider Details

I. General information

NPI: 1891312633
Provider Name (Legal Business Name): JOSHUA MCKINNEY PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2020
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 BROOKTREE RD STE 105
WEXFORD PA
15090-9299
US

IV. Provider business mailing address

PO BOX 16
ELLWOOD CITY PA
16117-0016
US

V. Phone/Fax

Practice location:
  • Phone: 724-271-8503
  • Fax:
Mailing address:
  • Phone: 724-674-1192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS020312
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS020312
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: