Provider Demographics
NPI:1679657068
Name:MACKE, KAREN (MA, LPC-S)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MACKE
Suffix:
Gender:F
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-3817
Mailing Address - Country:US
Mailing Address - Phone:828-400-3772
Mailing Address - Fax:888-522-1120
Practice Address - Street 1:563 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3817
Practice Address - Country:US
Practice Address - Phone:828-400-3772
Practice Address - Fax:888-522-1120
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7429101YP2500X
GA2749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104770Medicaid