Provider Demographics
NPI:1851153217
Name:BINKLEY, MACKENZIE ELISE (LCSW)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ELISE
Last Name:BINKLEY
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 1:318 VEST RD
Mailing Address - Street 2:
Mailing Address - City:HENRYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47126-9718
Mailing Address - Country:US
Mailing Address - Phone:812-631-7168
Mailing Address - Fax:
Practice Address - Street 1:318 VEST RD
Practice Address - Street 2:
Practice Address - City:HENRYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47126-9718
Practice Address - Country:US
Practice Address - Phone:812-631-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2582541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical