Basic Information
Provider Information
NPI: 1861934879
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKINNEY
FirstName: CORTNEY
MiddleName: REDMOND
NamePrefix: MRS.
NameSuffix: I
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 126 BUDDY AVE
Address2:  
City: GREER
State: SC
PostalCode: 296514504
CountryCode: US
TelephoneNumber: 8642384866
FaxNumber:  
Practice Location
Address1: 250 DEWEY SVE.
Address2:  
City: SPARTANBURG
State: SC
PostalCode: 29303
CountryCode: US
TelephoneNumber: 8645850366
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/08/2016
LastUpdateDate: 11/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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