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General NPI Number Information
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NPI Number | 1750449278
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Entity Type | Individual
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Provider Name | JENNIFER MCKEON LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 2000 OLD WEST CHESTER PIKE
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City | HAVERTOWN
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State | PA
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Zip | 19083-2712
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Country | US
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Telephone | 484-319-3804
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Fax |
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Provider Business Mailing Address
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Address Line | 78 N HAWTHORNE RD
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City | COATESVILLE
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State | PA
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Zip | 19320-1475
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Country | US
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Telephone |
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Fax |
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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 | C005288
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016876
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License Number State | PA
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