Provider Demographics
NPI:1649082421
Name:KIEFFER, MACKENZIE MARA
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:MARA
Last Name:KIEFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-1623
Mailing Address - Country:US
Mailing Address - Phone:724-775-7905
Mailing Address - Fax:
Practice Address - Street 1:373 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-1623
Practice Address - Country:US
Practice Address - Phone:724-775-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)