Provider Demographics
NPI:1093587404
Name:MACKOUL AND ASSOCIATES INC
Entity Type:Organization
Organization Name:MACKOUL AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKOUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-375-0155
Mailing Address - Street 1:27 DRIFTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2914
Mailing Address - Country:US
Mailing Address - Phone:508-375-0155
Mailing Address - Fax:
Practice Address - Street 1:27 DRIFTWOOD LN
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2914
Practice Address - Country:US
Practice Address - Phone:508-375-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty