Organization
CAROLE MACKENZIE LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. CAROLE HOLABIRD MACKENZIE LCSW (LICENSED CLINICAL SOCIAL WORKER)
(860) 231-7373
Entity
Organization
Contact information
Practice address
674 PROSPECT AVE, HARTFORD, CT 06105-4288
(860) 231-7373
(860) 233-5736
Mailing address
674 PROSPECT AVE, HARTFORD, CT 06105-4288
(860) 231-7373
(860) 233-5736
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
002083
CT
261QM0850X
Adult Mental Health Clinic/Center
002083
CT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
002083
CT
Other
Enumeration date
09/02/2014
Last updated
11/04/2014
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