Provider Demographics
NPI:1174672232
Name:MCKEE, BRUCE DEAN (LCSW)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:DEAN
Last Name:MCKEE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 N FRESNO ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2411
Mailing Address - Country:US
Mailing Address - Phone:559-446-1041
Mailing Address - Fax:559-435-3710
Practice Address - Street 1:7760 N FRESNO ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2411
Practice Address - Country:US
Practice Address - Phone:559-446-1041
Practice Address - Fax:559-435-3710
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 069091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical