Provider Demographics
NPI:1992315147
Name:CONTRERAS, MACKENZIE LUNA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:LUNA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:LUNA
Other - Last Name:BAXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:105 GROVELAND ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6619
Mailing Address - Country:US
Mailing Address - Phone:978-833-4270
Mailing Address - Fax:
Practice Address - Street 1:12 INGALLS CT
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3712
Practice Address - Country:US
Practice Address - Phone:978-686-2807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MA2268281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical