Provider Demographics
NPI:1548450182
Name:MCKEAN, JOSEPH M (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:MCKEAN
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 E FORT PIERCE DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8814
Mailing Address - Country:US
Mailing Address - Phone:435-688-4358
Mailing Address - Fax:
Practice Address - Street 1:1224 S RIVER RD STE B233
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7140
Practice Address - Country:US
Practice Address - Phone:435-688-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140859-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical