Individual provider Active NPI

Katelyn Emily Mackay

  • Social Worker
  • St Augustine, FL
National Provider Identifier
1124937487
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
495 Prosperity Lake Dr Ste 101
St Augustine, FL 32092-5045
Phone
(904) 370-3420
NPI assigned
Sep 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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 Primary

Addresses

Primary practice location

495 Prosperity Lake Dr Ste 101
St Augustine, FL 32092-5045

Mailing address

2211 Flourescent Way
South Daytona, FL 32119-2554
Phone (917) 391-8857

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1124937487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 FLOURESCENT WAY",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192554",
            "telephone_number": "917-391-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 PROSPERITY LAKE DR STE 101",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925045",
            "telephone_number": "904-370-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "KATELYN",
        "middle_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.