Individual
KYRA ELAINE MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AAS, CDC 1, PSP III
Contact information
Practice address
300 N WILLOW ST, WASILLA, AK 99654-7042
(907) 373-4357
Mailing address
300 N WILLOW ST, WASILLA, AK 99654-7042
(907) 373-4357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5359
AK
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
5131
AK
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1724897
—
AK
Enumeration date
10/04/2021
Last updated
04/30/2026
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