Provider Demographics
NPI:1831215300
Name:MACKEY, CAMILLE (LPC)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BROOKLYN RD
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-2876
Mailing Address - Country:US
Mailing Address - Phone:772-284-1468
Mailing Address - Fax:
Practice Address - Street 1:110 BROOKLYN RD
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-2876
Practice Address - Country:US
Practice Address - Phone:772-284-1468
Practice Address - Fax:201-455-5632
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018214Medicaid