Individual provider · Type 1 NPI
Mackenzie Kyra Wilson
Mental Health Counselor · Jacksonville, FL
NPI number
1194683581
Active
Practice location
12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1194683581
Mackenzie Kyra Wilson's National Provider Identifier is 1194683581, issued on Jan 13, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jacksonville, FL. The record was last updated on Jan 13, 2026.