Provider Demographics
NPI:1285968586
Name:MACKEY, ELEANOR RACE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:RACE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:MARIE
Other - Last Name:RACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3810 CALVERT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1820
Mailing Address - Country:US
Mailing Address - Phone:202-476-5307
Mailing Address - Fax:202-476-3966
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-5307
Practice Address - Fax:202-476-3966
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000484103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent