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General NPI Number Information
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NPI Number | 1518776178
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Entity Type | Organization
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Legal Business Name | MACKENZIE CONLEY COUNSELING, LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 6536 ANTHONY MARTIN APT 308
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City | NEW ALBANY
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State | OH
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Zip | 43054-3562
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Country | US
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Telephone | 419-979-8169
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Fax |
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Provider Business Mailing Address
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Address Line | 6536 ANTHONY MARTIN APT 308
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City | NEW ALBANY
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State | OH
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Zip | 43054-3562
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Country | US
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Telephone | 419-979-8169
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MACKENZIE CONLEY
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Credential | LPCC
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Telephone | 614-398-2032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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