Provider Demographics
NPI:1497970404
Name:MACEACHERN, ALLEN KENT (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:KENT
Last Name:MACEACHERN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:KENT
Other - Middle Name:
Other - Last Name:MACEACHERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1060 CLIFFWOOD DR # A
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3522
Mailing Address - Country:US
Mailing Address - Phone:843-849-0453
Mailing Address - Fax:843-849-6219
Practice Address - Street 1:1060 CLIFFWOOD DR # A
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3522
Practice Address - Country:US
Practice Address - Phone:843-849-0453
Practice Address - Fax:843-849-6219
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist