MEDICARE: SHAKIA MACKEY LPC

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	101YP2500X	Professional Counselor	0701014317	VA

General Provider Information

NPI Number	:	1467262626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKIA MACKEY LPC

Provider Business Mailing Address
First Line	:	710 KESWICK RD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1731
Country	:	US
Telephone Number	:	757-710-7664
Fax Number	:

Provider Business Practice Location Address
First Line	:	12020 SUNRISE VALLEY DR
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3440
Country	:	US
Telephone Number	:	757-710-7664
Fax Number	:

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

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	04/15/2025

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Directions to “ SHAKIA MACKEY LPC” Practice Location

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