| Doctor Name: | DAVE THOMAS MCKENNA |
| NPI Number: | 1144377359 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | 180005667 |
| Business Practice Address: | 2592 E Grand Ave Suite 202 Lindenhurst, IL - 600465915 |
| Business Phone Number: | 8476514719 |
| Business Fax Number: | |
| Mailing Address: | 1610 Oriole Ct, LINDENHURST |
| State: | IL |
| Postal Code: | 600469509 |
| Phone Number: | 8476514719 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 02/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180005667 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |