MEDICARE: MRS. MARILYN MACKEL

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1558479014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARILYN MACKEL

Provider Business Mailing Address
First Line	:	8208 CENTER PKWY APT 13
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5390
Country	:	US
Telephone Number	:	916-361-2089
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 HARRIS AVE STE A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95838-3249
Country	:	US
Telephone Number	:	916-659-6680
Fax Number	:	916-659-6680

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

Provider Enumeration Date	:	08/26/2006
Last Update Date	:	02/13/2026

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