Individual provider Active NPI

Mackenzie Kew, LCSW

  • Clinical Social Worker
  • Jackson, WY
National Provider Identifier
1356026694
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-1569 Issued in WY
Practice address
640 E Broadway Ave
Jackson, WY 83001-8642
Phone
(307) 733-2046
Fax
(307) 733-6289
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-1569 WY Primary

Addresses

Primary practice location

640 E Broadway Ave
Jackson, WY 83001-8642

Mailing address

PO Box 1868
Jackson, WY 83001-1868
Phone (307) 733-2046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809000746 WY Practitioner - Clinical Social Worker 6709248685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health and Recovery Services of Jackson HoleGroup PAC ID 0840272472, 10 clinicians

Practice addresses (Care Compare)

640 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-2046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-1569WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health & Recovery Services of Jackson Hole CurrentSince Jun 26, 2023 Accepting new patients
Mental Health & Recovery Services of Jackson Hole CurrentSince Nov 7, 2025 Accepting new patients

Organizations & group practices 2

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": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1356026694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1868",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011868",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEW",
        "first_name": "MACKENZIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.