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General NPI Number Information
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NPI Number | 1013017771
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Entity Type | Individual
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Provider Name | NANCY C MCKENNA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 747 MADISON AVE STE 2
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City | ALBANY
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State | NY
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Zip | 12208-3392
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Country | US
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Telephone | 518-755-0611
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Fax | 518-755-0611
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Provider Business Mailing Address
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Address Line | 33 BENDER LN
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City | DELMAR
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State | NY
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Zip | 12054-4321
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Country | US
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Telephone | 518-527-0099
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Fax | 518-439-4662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R056814-1
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License Number State | NY
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