Individual provider Active NPI

McKenzie Litaker, LICSW

  • Social Worker
  • Montgomery, AL
National Provider Identifier
1093561409
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5716C Issued in AL
Practice address
7475 Halcyon Pointe Dr
Montgomery, AL 36117-8053
Phone
(334) 954-6010
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5716C AL Primary

Addresses

Primary practice location

7475 Halcyon Pointe Dr
Montgomery, AL 36117-8053

Mailing address

5551 Deatsville Hwy
Deatsville, AL 36022-6011
Phone (334) 322-9758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240523001843 AL Practitioner - Clinical Social Worker 2769824671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gardenia Cove Mental Health PCGroup PAC ID 0648534537, 40 clinicians

Practice addresses (Care Compare)

7475 Halcyon Pointe Dr
Montgomery, AL 36117-8053
Phone (334) 954-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5716CALMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gardenia Cove Mental Health PC CurrentSince May 3, 2024 Accepting new patients

Locations

7475 Halcyon Pointe Dr
Montgomery, AL 36117
Phone (334) 954-6010

Organizations & group practices 1

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": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1093561409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 DEATSVILLE HWY",
            "city": "DEATSVILLE",
            "state": "AL",
            "postal_code": "360226011",
            "telephone_number": "334-322-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7475 HALCYON POINTE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178053",
            "telephone_number": "334-954-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITAKER",
        "first_name": "MCKENZIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "5716C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.