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General NPI Number Information
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NPI Number | 1033590039
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Entity Type | Individual
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Provider Name | MAKENZIE CHENEY M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 3491 GANDY BLVD N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2658
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Country | US
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Telephone | 407-760-6678
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 MONTROSE CIR
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City | PALM HARBOR
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State | FL
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Zip | 34684-1828
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH14359
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License Number State | FL
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