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NPI Code Detail

MEDICARE: MS. KATHLEEN MARIE BAPTISTE-MCKINNEY LCSW

MEDICARE: MS. KATHLEEN MARIE BAPTISTE-MCKINNEY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1765OR

General Provider Information

NPI Number : 1023174166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN MARIE BAPTISTE-MCKINNEY LCSW
Provider Business Mailing Address
First Line : 1698 LIBERTY ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4348
Country : US
Telephone Number : 503-363-5435
Fax Number : 503-364-7272
Provider Business Practice Location Address
First Line : 1698 LIBERTY ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4348
Country : US
Telephone Number : 503-363-5435
Fax Number : 503-364-7272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2006
Last Update Date : 07/29/2009

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Directions to “ MS. KATHLEEN MARIE BAPTISTE-MCKINNEY LCSW” Practice Location

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