Provider Demographics
NPI:1033514534
Name:MACKEY, TOYUR V (LMSW)
Entity Type:Individual
Prefix:
First Name:TOYUR
Middle Name:V
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TOYUR
Other - Middle Name:V
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24354 ECORSE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1643
Mailing Address - Country:US
Mailing Address - Phone:313-292-5300
Mailing Address - Fax:313-899-7053
Practice Address - Street 1:24354 ECORSE RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-1643
Practice Address - Country:US
Practice Address - Phone:313-292-5300
Practice Address - Fax:313-899-7053
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010772601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI5690Medicare UPIN