Healthcare Provider Details

I. General information

NPI: 1407788334
Provider Name (Legal Business Name): MACKENZIE LESKOVAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 N PITT ST
MERCER PA
16137-1129
US

IV. Provider business mailing address

456 N PITT ST
MERCER PA
16137-1129
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-7202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: