Individual provider Active NPI

McKenzie N Nickerson, MS, LPC

  • Professional Counselor
  • Springfield, MO
National Provider Identifier
1043807456
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2021005306 Issued in MO
Practice address
630 W Kearney St
Springfield, MO 65803-2508
Phone
(417) 761-5000
Fax
(417) 761-5011
NPI assigned
Dec 31, 2020
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2021005306 MO Primary

Addresses

Primary practice location

630 W Kearney St
Springfield, MO 65803-2508

Mailing address

PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214

Other names 1

  • McKenzie Ozee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227000239 MO Practitioner - Mental Health Counselor 0446600977 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021005306MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Current Accepting new patients
Burrell, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Burrell, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2024 Accepting new patients

Locations

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
#H
Springfield, MO 65804

1423 N Jefferson Ave
Fl 3
Springfield, MO 65802
Phone (417) 761-5820

1423 N Jefferson Ave
Ste D200
Springfield, MO 65802
Phone (417) 761-5820

3525 S National Ave
Ste 206
Springfield, MO 65807
Phone (417) 269-9200

630 W Kearney St
Springfield, MO 65803
Phone (417) 761-5300

Networks

  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1043807456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "telephone_number": "417-761-5214",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658032508",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "MCKENZIE",
        "middle_name": "N",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2021005306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "OZEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.