Healthcare Provider Details

I. General information

NPI: 1851199939
Provider Name (Legal Business Name): MAKAYLA MARIE ANSELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 8TH ST
WINDBER PA
15963-1420
US

IV. Provider business mailing address

503 8TH ST
WINDBER PA
15963-1420
US

V. Phone/Fax

Practice location:
  • Phone: 582-855-9694
  • Fax:
Mailing address:
  • Phone: 582-855-9694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: