MEDICARE: EMMALEE MACKEY

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	I.2507064	OH

General Provider Information

NPI Number	:	1760156111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMALEE MACKEY

Provider Business Mailing Address
First Line	:	8200 BECKETT PARK DR STE 111
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-9316
Country	:	US
Telephone Number	:	513-254-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	8200 BECKETT PARK DR
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-9310
Country	:	US
Telephone Number	:	513-991-7007
Fax Number	:

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

Provider Enumeration Date	:	08/08/2021
Last Update Date	:	08/15/2025

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Directions to “ EMMALEE MACKEY ” Practice Location

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