MEDICARE: CHALONDA MCKINLEY

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	101YP2500X	Professional Counselor	016295	GA
2	101YM0800X	Mental Health Counselor	016295	GA

General Provider Information

NPI Number	:	1346695780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHALONDA MCKINLEY

Provider Business Mailing Address
First Line	:	PO BOX 5784
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95150-5784
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1887 DULUTH HWY
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30043-5074
Country	:	US
Telephone Number	:	404-616-4853
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	04/17/2026

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Directions to “ CHALONDA MCKINLEY ” Practice Location

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