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SAMANTHA MACKEY
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1255993457
Individual Registrant: SAMANTHA MACKEY
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 855-534-3105 Fax: 844-587-6405
Tel: 855-534-3105 Fax: 844-587-6405
Contact information for business:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 855-343-1057 Fax: 844-587-6405
Tel: 855-343-1057 Fax: 844-587-6405
Registration Information:
NPI: 1255993457
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | ||
| Y | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
