Provider Demographics
NPI:1649738675
Name:MACKEY, ROBIN (LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2547
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74402-2547
Mailing Address - Country:US
Mailing Address - Phone:918-681-1113
Mailing Address - Fax:918-681-1116
Practice Address - Street 1:1305 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-7802
Practice Address - Country:US
Practice Address - Phone:918-681-1113
Practice Address - Fax:918-681-1116
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional