Healthcare Provider Details

I. General information

NPI: 1902743610
Provider Name (Legal Business Name): MAKENNA OLIVIA MCCLOSKEY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 MAIN STREET SUITE 2A
PALMER MA
01069
US

IV. Provider business mailing address

PO BOX 214
MONSON MA
01057-0214
US

V. Phone/Fax

Practice location:
  • Phone: 413-265-0171
  • Fax:
Mailing address:
  • Phone: 413-265-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002089
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: