Provider Demographics
NPI:1114958303
Name:MACKEY, DAVID WARREN (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WARREN
Last Name:MACKEY
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:MAIL CODE 116A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-631-7127
Mailing Address - Fax:813-631-7128
Practice Address - Street 1:11707 CLUB DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5521
Practice Address - Country:US
Practice Address - Phone:813-631-7127
Practice Address - Fax:813-631-7128
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 71301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical