Individual provider Active NPI

Catherine Therese McKenzie, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1104902303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KY1133 Issued in KY
Practice address
201 Mechanic St
Blue Grass Comp Care Gratz Park Clinic
Lexington, KY 40507
Phone
(859) 233-0444
Fax
(859) 233-0144
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X KY1133 KY Primary

Addresses

Primary practice location

201 Mechanic St
Blue Grass Comp Care Gratz Park Clinic
Lexington, KY 40507

Mailing address

201 Mechanic St
Blue Grass Comp Care Gratz Park Clinic
Lexington, KY 40507
Phone (859) 233-0444

Other identifiers 1

IdentifierTypeStateIssuer
30615058MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY1133KYMDClinical Social Worker
1133KYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104902303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MECHANIC ST",
            "address_2": "BLUE GRASS COMP CARE GRATZ PARK CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40507",
            "telephone_number": "859-233-0444",
            "fax_number": "859-233-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MECHANIC ST",
            "address_2": "BLUE GRASS COMP CARE GRATZ PARK CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40507",
            "telephone_number": "859-233-0444",
            "fax_number": "859-233-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "CATHERINE",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY1133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.