Provider Demographics
NPI:1750782207
Name:MACKECHNIE, JENNIFER A (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:MACKECHNIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:MACKECHNIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:5 RUSSETT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5326
Mailing Address - Country:US
Mailing Address - Phone:401-845-0344
Mailing Address - Fax:
Practice Address - Street 1:747 AQUIDNECK AVE UNIT 2H1
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7265
Practice Address - Country:US
Practice Address - Phone:401-824-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health