Jennifer Mackay, BSW
Individual provider Active NPI Social Worker · Hesperia, MI
NPI 1023577665 · NPPES record last updated Jan 30, 2023
Key facts
- NPI
- 1023577665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802085401 (MI)
- Practice address
- 9070 8TH St
Hesperia, MI 49421-9403 - Phone
- (616) 717-8191
- NPI assigned
- Mar 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802085401 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802085401 | MI | Yes |
Addresses
Primary practice location
9070 8TH St
Hesperia, MI 49421-9403
Mailing address
9070 8TH St
Hesperia, MI 49421-9403
Phone (616) 717-8191
Other providers in Hesperia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.