Provider Demographics
NPI:1699364604
Name:WINCHESTER, MCKENZIE (MFT)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S LINE ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-8510
Mailing Address - Country:US
Mailing Address - Phone:610-755-1801
Mailing Address - Fax:
Practice Address - Street 1:222 N WALNUT ST STE E
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2608
Practice Address - Country:US
Practice Address - Phone:714-348-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist