Doctor Name: | MR. KEMSEY MACKEY |
NPI Number: | 1043625395 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, LMFT |
License Number: | 37FI00050300 |
Business Practice Address: | 33 S Fullerton Ave Montclair, NJ - 070423358 |
Business Phone Number: | 9735099777 |
Business Fax Number: | 9732338299 |
Mailing Address: | 31 S Fullerton Ave, MONTCLAIR |
State: | NJ |
Postal Code: | 070423455 |
Phone Number: | 9735099777 |
Fax Number: | 9732338299 |
NPI Enumeration Date: | 06/25/2014 |
NPI Last Update Date: | 06/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 37FI00050300 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |