MEDICARE: MAKENZI COOLEY LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	002687	NY
2	106H00000X	Marriage & Family Therapist	F.2600596	OH

General Provider Information

NPI Number	:	1114734845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKENZI COOLEY LMFT

Provider Business Mailing Address
First Line	:	8009 78TH AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7626
Country	:	US
Telephone Number	:	347-255-2755
Fax Number	:

Provider Business Practice Location Address
First Line	:	8009 78TH AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7626
Country	:	US
Telephone Number	:	347-255-2755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	05/21/2026

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Directions to “ MAKENZI COOLEY LMFT” Practice Location

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