Makenzie McMahon, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4399 Issued in MN

Practice address

3535 Plymouth Blvd Ste 110
Plymouth, MN 55447-1393

Phone

(651) 401-5010

NPI assigned

Jul 31, 2023

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Wild Tree Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1528451408
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1164103297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 ROBERT ST",
            "city": "PRESCOTT",
            "state": "WI",
            "postal_code": "540212300",
            "telephone_number": "715-418-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PLYMOUTH BLVD STE 110",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471393",
            "telephone_number": "651-401-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "MAKENZIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randee McGown, PA
• Ronald McGown, M.D.
• Matthew McGraw, SCHOOL PSYCHOLOGIST
• Mitchell W McGraw
• Amanda Irene McMahon
• Paul James McManus, DO
• Melissa McNeely
• Duane Cary McNeil, D.D.S.
• Allison McNulty, DPT
• Jennifer McVann, MS, LMFT

• Mental Health Counselor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.