Provider Demographics
NPI:1346828027
Name:KOZAK, MACKENZIE ALLEN (LCMHC, MA)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ALLEN
Last Name:KOZAK
Suffix:
Gender:F
Credentials:LCMHC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9350
Mailing Address - Country:US
Mailing Address - Phone:920-470-2388
Mailing Address - Fax:
Practice Address - Street 1:44 MERRIMON AVE STE 1C
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2352
Practice Address - Country:US
Practice Address - Phone:828-290-9407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health