Individual provider Active NPI

Makenzie Nelson, LCSW

  • Mental Health Counselor
  • Winter Haven, FL
National Provider Identifier
1053200402
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW24966 Issued in FL
Practice address
1501 1St St S
Winter Haven, FL 33880-4307
Phone
(863) 291-3611
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW24966 FL Primary
Clinical Social Worker 1041C0700X 24966 FL

Addresses

Primary practice location

1501 1St St S
Winter Haven, FL 33880-4307

Mailing address

1501 1St St S
Winter Haven, FL 33880-4307
Phone (863) 291-3611

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Makenzie.NelsonLCSW@direct.mybaycare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250729002579 FL Practitioner - Clinical Social Worker 5294242731 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24966FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Winter Haven Hospital Inc CurrentSince Aug 31, 2025 Accepting new patients
Winter Haven Hospital Inc CurrentSince Aug 31, 2025 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

1501 1st St S
Winter Haven, FL 33880
Phone (813) 738-6689

1201 1st St S
Winter Haven, FL 33880
Phone (863) 294-7062

Interoperability endpoints

  • Direct secure messaging: makenzie.nelsonlcsw@direct.mybaycare.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1053200402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804307",
            "telephone_number": "863-291-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804307",
            "telephone_number": "863-291-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MAKENZIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW24966",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "24966",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Makenzie.NelsonLCSW@direct.mybaycare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1501 1st St S",
            "city": "Winter Haven",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338804307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.