Provider Demographics
NPI:1265285084
Name:MCKENZIE, LASHAWN MARIE (MSW)
Entity type:Individual
Prefix:
First Name:LASHAWN
Middle Name:MARIE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5284 FLOYD RD SW UNIT 223
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-6101
Mailing Address - Country:US
Mailing Address - Phone:770-212-1515
Mailing Address - Fax:
Practice Address - Street 1:5284 FLOYD RD SW UNIT 223
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-6101
Practice Address - Country:US
Practice Address - Phone:770-212-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker