Provider Demographics
NPI:1417980046
Name:MACKLER, MEL (LMFT)
Entity Type:Individual
Prefix:MR
First Name:MEL
Middle Name:
Last Name:MACKLER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CAMINO DEL RIO S STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3719
Mailing Address - Country:US
Mailing Address - Phone:619-291-2511
Mailing Address - Fax:619-294-3012
Practice Address - Street 1:2525 CAMINO DEL RIO S STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3719
Practice Address - Country:US
Practice Address - Phone:619-291-2511
Practice Address - Fax:619-294-3012
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT12771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health