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General NPI Number Information
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NPI Number | 1972820256
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Entity Type | Individual
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Provider Name | HEATHER MARIE MCKENZIE M.S., LCMHCS
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Gender | Female
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 3434 KILDAIRE FARM RD SUITE 135 - 535
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City | RALEIGH
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State | NC
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Zip | 27518-2278
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Country | US
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Telephone | 919-744-8335
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Fax | 844-644-3163
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Provider Business Mailing Address
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Address Line | 620 PENNCROSS DR
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City | RALEIGH
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State | NC
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Zip | 27610-2177
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Country | US
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Telephone | 919-744-8335
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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 | NC
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