Provider Demographics
NPI:1659619534
Name:MCMACKINS, CHARITY PARKER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHARITY
Middle Name:PARKER
Last Name:MCMACKINS
Suffix:
Gender:F
Credentials:LCSW
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 653
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37111-0653
Mailing Address - Country:US
Mailing Address - Phone:615-618-3551
Mailing Address - Fax:
Practice Address - Street 1:107 N SPRING ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2531
Practice Address - Country:US
Practice Address - Phone:615-618-3551
Practice Address - Fax:615-563-9740
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN57281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical