Provider Demographics
NPI:1184394272
Name:MUSIC, MAKAYLEE (LSW)
Entity type:Individual
Prefix:
First Name:MAKAYLEE
Middle Name:
Last Name:MUSIC
Suffix:
Gender:F
Credentials:LSW
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 498
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-0498
Mailing Address - Country:US
Mailing Address - Phone:419-908-5542
Mailing Address - Fax:
Practice Address - Street 1:380 CLINE AVE STE 3
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1056
Practice Address - Country:US
Practice Address - Phone:419-606-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2005664104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker