Mackenzie G Wallin, BA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

401 W. International Airport Rd.
Suite 17
Anchorage, AK 99518-1168

Phone

(907) 770-3656

Fax

(907) 562-4503

NPI assigned

Jul 11, 2019

Last updated

Nov 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Milton G Wallin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Volunteers of America Alaska, Benny SS

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1427679307
  NPD (past)

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1154973022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W. INTERNATIONAL AIRPORT RD.",
            "address_2": "SUITE 17",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181168",
            "telephone_number": "907-770-3656",
            "fax_number": "907-562-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W. INTERNATIONAL AIRPORT RD.",
            "address_2": "SUITE 17",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181168",
            "telephone_number": "907-770-3656",
            "fax_number": "907-562-4503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Cordova St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995032745",
            "country_code": "US",
            "telephone_number": "907-279-9634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4515 Campbell Airstrip Rd",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995071267",
            "country_code": "US",
            "telephone_number": "907-279-9640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "MACKENZIE",
        "middle_name": "G",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2023-11-02",
        "certification_date": "2020-07-30",
        "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": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILTON",
            "last_name": "WALLIN",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan 'Suzi' Wallace, PSYCHOLOGIST
• Destiny Waller
• Samuel Thomas Dunn Waller, MD
• Michael Walleri, DO
• Jeri R Wallin, EMT III
• Gordon Jay Wallis, LMT.
• Elizabeth Wallmann-Filley, LMSW
• Vanessa Walluk
• Walmart Inc. (Walmart Pharmacy 10-2070)
• Walmart Inc. (Walmart Pharmacy 10-2071)

• Mental Health Counselor in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.