Provider Demographics
NPI:1427723931
Name:MACKAY BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:MACKAY BEHAVIORAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKAY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, CRNP-PMH
Authorized Official - Phone:240-883-4025
Mailing Address - Street 1:8000 JUMPERS HOLE RD STE 217
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1046
Mailing Address - Country:US
Mailing Address - Phone:240-883-4025
Mailing Address - Fax:
Practice Address - Street 1:8000 JUMPERS HOLE RD STE 217
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1046
Practice Address - Country:US
Practice Address - Phone:240-883-4025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty