Provider Demographics
NPI:1831258524
Name:MACKEY, SUSAN MARIE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARIE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 57TH AVENUE CIR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-5327
Mailing Address - Country:US
Mailing Address - Phone:941-962-8864
Mailing Address - Fax:941-751-8003
Practice Address - Street 1:NEW VIEW COUNSELING
Practice Address - Street 2:4506 26TH STREET WEST SUITE C
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207
Practice Address - Country:US
Practice Address - Phone:941-751-8003
Practice Address - Fax:941-751-8003
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health