Provider Demographics
NPI:1144253253
Name:MACKELL TRAINING & CONSULTANTS INC.
Entity type:Organization
Organization Name:MACKELL TRAINING & CONSULTANTS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELMIRA
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-355-2124
Mailing Address - Street 1:4915 RADFORD AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3528
Mailing Address - Country:US
Mailing Address - Phone:804-355-2124
Mailing Address - Fax:804-355-2047
Practice Address - Street 1:4915 RADFORD AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3528
Practice Address - Country:US
Practice Address - Phone:804-355-2124
Practice Address - Fax:804-355-2047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002787251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA184802OtherHEALTHKEEPRS PLUS & PPO