Provider Demographics
NPI:1750692596
Name:MCKENZIE-DAY, PAULINE ANN (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:ANN
Last Name:MCKENZIE-DAY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 CLAIRMONT RD
Mailing Address - Street 2:STE 160
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3438
Mailing Address - Country:US
Mailing Address - Phone:404-593-8444
Mailing Address - Fax:404-968-9262
Practice Address - Street 1:1924 CLAIRMONT RD
Practice Address - Street 2:STE 160
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3438
Practice Address - Country:US
Practice Address - Phone:404-593-8444
Practice Address - Fax:404-968-9262
Is Sole Proprietor?:No
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional