1831258524 NPI number — MRS. SUSAN MARIE MACKEY LMHC

Table of content: LEORA BERNSTEIN M.A. (NPI 1184832636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831258524 NPI number — MRS. SUSAN MARIE MACKEY LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACKEY
Provider First Name:
SUSAN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831258524
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3117 57TH AVENUE CIR E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRADENTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34203-5327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-962-8864
Provider Business Mailing Address Fax Number:
941-751-8003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEW VIEW COUNSELING
Provider Second Line Business Practice Location Address:
4506 26TH STREET WEST SUITE C
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-751-8003
Provider Business Practice Location Address Fax Number:
941-751-8003
Provider Enumeration Date:
12/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH8387 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)