Mackenzie L Taylor, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60495001 Issued in WA

Practice address

1655 Hudson St Ste 5
Longview, WA 98632-2949

Phone

(503) 926-9413

Fax

(360) 967-8030

NPI assigned

Feb 11, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mackenzie Taylor

  • Clinical Social Worker
  • Lake Oswego, OR
  • NPI 1487516753
  NPD Authorized official
• C Q Psychological PLLC

  • Psychologist
  • Longview, WA
  • NPI 1619500477
  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1114166337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 HUDSON ST STE 5",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322949",
            "telephone_number": "503-926-9413",
            "fax_number": "360-967-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 HUDSON ST STE 5",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322949",
            "telephone_number": "503-926-9413",
            "fax_number": "360-967-8030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 NE Irving St",
            "address_2": "# 250",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322243",
            "country_code": "US",
            "telephone_number": "503-341-2340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322555",
            "country_code": "US",
            "telephone_number": "360-414-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MACKENZIE",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60495001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke J Taylor
• Debra Jean Taylor, MSW
• Elvina Irene Taylor, OTR/L
• Jennifer Lynn Taylor, M. ED
• Jessica Lea Taylor, HOME CARE AIDE
• Michelle Taylor, BA, AAC
• Samantha Taylor
• Tina M Taylor, ARNP
• Brittney Morghan Teaney
• Suzanne Tear, MA

• Clinical Social Worker in Longview, WA
• Providers in Longview, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.