Provider Demographics
NPI:1174338909
Name:BRICKER, MACKENZIE ANN (LPC)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ANN
Last Name:BRICKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:A
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:327 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2505
Mailing Address - Country:US
Mailing Address - Phone:717-632-1800
Mailing Address - Fax:717-632-1800
Practice Address - Street 1:327 BROADWAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2505
Practice Address - Country:US
Practice Address - Phone:717-632-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC019267101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional