Provider Demographics
NPI:1689484610
Name:MACKIE, ALESIA KAHLIA
Entity type:Individual
Prefix:
First Name:ALESIA
Middle Name:KAHLIA
Last Name:MACKIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 OAK DR SE # C112
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-5924
Mailing Address - Country:US
Mailing Address - Phone:202-251-8553
Mailing Address - Fax:
Practice Address - Street 1:1275 OAK DR SE # C112
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5924
Practice Address - Country:US
Practice Address - Phone:202-251-8553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral