Provider Demographics
NPI:1407531031
Name:MAC COUNSELING, LLC
Entity Type:Organization
Organization Name:MAC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ-WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:863-226-9112
Mailing Address - Street 1:475 COUNTY ROAD 561
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-9217
Mailing Address - Country:US
Mailing Address - Phone:863-226-9112
Mailing Address - Fax:
Practice Address - Street 1:830 N OUIDA ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2704
Practice Address - Country:US
Practice Address - Phone:334-475-2422
Practice Address - Fax:334-475-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty