Healthcare Provider Details

I. General information

NPI: 1629029178
Provider Name (Legal Business Name): JAMES EDWARD MCKINNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 JOHNNIE DODDS BLVD STE 200
MOUNT PLEASANT SC
29464-3044
US

IV. Provider business mailing address

958 EQUESTRIAN DR
MT PLEASANT SC
29464-3608
US

V. Phone/Fax

Practice location:
  • Phone: 843-607-4496
  • Fax: 501-290-4865
Mailing address:
  • Phone: 843-607-4496
  • Fax: 501-290-4865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16823
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: