Individual
KRISTY MACKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1530 N COMMERCE W DR, GREENSBURG, IN 47240-3205
(812) 663-7057
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
39004096A
IN
Other
Enumeration date
04/13/2007
Last updated
11/19/2021
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