Kylie Mackenzie

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

22471 Aspan St Ste 103
Lake Forest, CA 92630-1644

Phone

(949) 458-2715

NPI assigned

Sep 10, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Telecare Corporation

  • Mental Illness Community Based Residential Treatment Facility
  • San Diego, CA
  • NPI 1275398935
  NPD (past)
• Telecare Corporation

  • Psychiatric Residential Treatment Facility
  • Anaheim, CA
  • NPI 1902312564
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1003217993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 W BEACON AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044406",
            "telephone_number": "657-276-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22471 ASPAN ST STE 103",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301644",
            "telephone_number": "949-458-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "KYLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel M Simon
• Kathy Maasoumi, D.D.S.
• Jocelyn Macias, OTR/L
• Maureen Catherine Macias, LCSW
• Marla Faith Maciel, L.C.S.W.
• Victoria Eileen Madden
• Shidrokh Mafi, DDS
• Magic Potion Inc
• Ariana Mah, D.P.T.
• Mahroo Dental Corporation

• Mental Health Counselor in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.