Provider Demographics
NPI:1053130765
Name:BUDAY, MACKENZIE LYN (LMSW)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:LYN
Last Name:BUDAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EDISON RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3602
Mailing Address - Country:US
Mailing Address - Phone:203-278-2839
Mailing Address - Fax:
Practice Address - Street 1:200 EDISON RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3602
Practice Address - Country:US
Practice Address - Phone:724-681-8704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142179104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker