Healthcare Provider Details

I. General information

NPI: 1477488799
Provider Name (Legal Business Name): LAFREEDA MACKEY CNA, PCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 SOUTHERN AVE APT 101
CAPITOL HEIGHTS MD
20743-6871
US

IV. Provider business mailing address

4161 SOUTHERN AVE APT 101
CAPITOL HEIGHTS MD
20743-6871
US

V. Phone/Fax

Practice location:
  • Phone: 202-421-0334
  • Fax:
Mailing address:
  • Phone: 202-421-0334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: