Individual provider Active NPI

Mackenzie Gilliland

  • Mental Health Counselor
  • Louisville, KY
National Provider Identifier
1235877432
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
277220 Issued in KY
Practice address
1169 Eastern Pkwy Ste 1226
Louisville, KY 40217-1462
Phone
(660) 726-2030
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 277220 KY Primary

Addresses

Primary practice location

1169 Eastern Pkwy Ste 1226
Louisville, KY 40217-1462

Mailing address

1169 Eastern Pkwy Ste 1226
Louisville, KY 40217-1462
Phone (502) 822-7679

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

State licenses

LicenseStateTypeSpecialty
277220KYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1235877432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY STE 1226",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171462",
            "telephone_number": "502-822-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY STE 1226",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171462",
            "telephone_number": "660-726-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "277220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.