Individual
KYRA ELAINE MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AAS, CDC 1, PSP III
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
Update your record
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