Active NPI
Laura M Mackner, PH.D
- Clinical Psychologist
- Pataskala, OH
National Provider Identifier
1235148958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P.5812
- Practice address
- 9734 Jug St. NW
PBJ Connections
Pataskala, OH 43062 - Phone
- (740) 924-7543
- Fax
- (740) 924-2002
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5812 | OH | |
| Clinical Psychologist | 103TC0700X | P.5812 | OH | Primary |
Addresses
Primary practice location
9734 Jug St. NW
PBJ Connections
Pataskala, OH 43062
Mailing address
335 Northridge Rd
Columbus, OH 43214-3327
Phone (614) 596-8574
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2302056 | Other | OH | BCMH |
| 2302056 | Medicaid | OH |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P.5812 | OH | MD | Clinical Psychologist |
| 5812 | OH | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PBJ Connections, Inc. | Multi-Specialty | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752883200000",
"number": "1235148958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 NORTHRIDGE RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143327",
"telephone_number": "614-596-8574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9734 JUG ST. NW",
"address_2": "PBJ CONNECTIONS",
"city": "PATASKALA",
"state": "OH",
"postal_code": "43062",
"telephone_number": "740-924-7543",
"fax_number": "740-924-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKNER",
"first_name": "LAURA",
"middle_name": "M",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2025-07-19",
"certification_date": "2025-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5812",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "P.5812",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCMH",
"identifier": "2302056",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2302056",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pataskala, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.