Provider Demographics
NPI:1043689300
Name:MACKEY, SARA ANNE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:ANNE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 APPLEGARTH RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5347
Mailing Address - Country:US
Mailing Address - Phone:732-655-4239
Mailing Address - Fax:
Practice Address - Street 1:3124 PARKWAY
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1255
Practice Address - Country:US
Practice Address - Phone:443-616-5587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC151393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health