MEDICARE: MARY CATHERINE MCKENNA M.A., L.P.

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
1	103T00000X	Psychologist	LP0831	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	336K4MC	OTHER	MN	BLUE CROSS BLUE SHIELD
2	336K5MC	OTHER	MN	BCBS INDIVDUAL #

General Provider Information

NPI Number	:	1053397646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CATHERINE MCKENNA M.A., L.P.

Provider Business Mailing Address
First Line	:	1316 KNOLLWOOD LN
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55118-1739
Country	:	US
Telephone Number	:	651-552-6762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1316 KNOLLWOOD LN
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55118-1739
Country	:	US
Telephone Number	:	651-552-6762
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1235340373 — JOHN R. MARINUCCI, D.DS., LTD.
Practice Location Address:

414 DIXIE HWY
CHICAGO HEIGHTS, IL
60411-1739

Practice Phone: 708-754-7505
Practice Fax: 708-754-5576

1356506513 — MR. YONG LEE L.P.C
Practice Location Address:

204 WHITE HORSE PIKE , 2ND FLOOR
HADDON HEIGHTS, NJ
08035-1739

Practice Phone: 609-314-9719
Practice Fax:

1740427376 — TEKISHA CUNNINGHAM LPN
Practice Location Address:

2187 NOBLE RD STE 101
CLEVELAND HEIGHTS, OH
44112-1739

Practice Phone: 216-505-4390
Practice Fax:

1669606695 — VICTORIOUS HOME HEALTH CARE LIMITED
Practice Location Address:

414 DIXIE HWY
CHICAGO HEIGHTS, IL
60411-1739

Practice Phone: 815-464-9201
Practice Fax: 815-464-9202

1639494792 — MONICA NGO RPH
Practice Location Address:

22404 LINDEN BLVD
CAMBRIA HEIGHTS, NY
11411-1739

Practice Phone: 347-548-5250
Practice Fax:

1770920795 — MAKKI PHARMACY & SURGICAL INC
Practice Location Address:

22404 LINDEN BLVD
CAMBRIA HEIGHTS, NY
11411-1739

Practice Phone: 347-548-5250
Practice Fax:

Directions to “ MARY CATHERINE MCKENNA M.A., L.P.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.