Healthcare Provider Details

I. General information

NPI: 1396606497
Provider Name (Legal Business Name): MACKENZIE CAROL SCHWEIKHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BRADLEY RD STE 404
WOODBRIDGE CT
06525-2235
US

IV. Provider business mailing address

1 BRADLEY RD STE 404
WOODBRIDGE CT
06525-2235
US

V. Phone/Fax

Practice location:
  • Phone: 203-298-9005
  • Fax: 203-298-9453
Mailing address:
  • Phone: 203-298-9453
  • Fax: 203-298-9454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: