Healthcare Provider Details

I. General information

NPI: 1366354078
Provider Name (Legal Business Name): MACKENZIE LYNNE LEARY LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 1ST AVE NW
HICKORY NC
28601-6124
US

IV. Provider business mailing address

439 1ST AVE NW
HICKORY NC
28601-6124
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-4941
  • Fax: 828-322-4931
Mailing address:
  • Phone: 828-322-4941
  • Fax: 828-322-4931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23490
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: