Provider Demographics
NPI:1861790057
Name:KINNEY, DENISE N (LMHC, NCC)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:N
Last Name:KINNEY
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-2814
Mailing Address - Country:US
Mailing Address - Phone:712-250-4568
Mailing Address - Fax:
Practice Address - Street 1:2114 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-2814
Practice Address - Country:US
Practice Address - Phone:712-250-4568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
296081OtherNATIONALLY CERTIFIED COUNSELOR, NCC
IA600754509Medicaid