Provider Demographics
NPI:1497395347
Name:MACKENSWORTH, FAITH (LMHC, MS, NCC)
Entity Type:Individual
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First Name:FAITH
Middle Name:
Last Name:MACKENSWORTH
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Gender:F
Credentials:LMHC, MS, NCC
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Mailing Address - Street 1:12240 BAIR LAKE ST
Mailing Address - Street 2:
Mailing Address - City:JONES
Mailing Address - State:MI
Mailing Address - Zip Code:49061-8711
Mailing Address - Country:US
Mailing Address - Phone:219-263-6058
Mailing Address - Fax:
Practice Address - Street 1:2004 VALPARAISO ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3138
Practice Address - Country:US
Practice Address - Phone:319-477-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2023-08-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health