Mackenzie Lyn Ayers, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011072 Issued in VA

Practice address

25460 Stallion Branch Ter
Chantilly, VA 20152-5809

Phone

(571) 390-8999

NPI assigned

Oct 21, 2019

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

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  • NPI 1447868575
  NPD
• Dan Roth, PLLC

  • Mental Health Counselor
  • Herndon, VA
  • NPI 1417802315
  NPD (past)

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1396388690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 BROOKFIELD CORPORATE DRIVE",
            "address_2": "#220941",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201538034",
            "telephone_number": "571-390-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25460 STALLION BRANCH TER",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525809",
            "telephone_number": "571-390-8999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2579 John Milton Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201712564",
            "country_code": "US",
            "telephone_number": "703-214-4924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYERS",
        "first_name": "MACKENZIE",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aural Rehab Services
• Aurum Foundation (Aurum Home)
• Aurum Providence LLC
• Tamara Avery, FNP
• Michael S. Axler, PSY.D.
• Melissa Dawn Ayers, ANP
• Hira Azam
• Negin Azhandeh, O.D.
• Bahareh Azizi, PHARM-D
• Baba Atal LLC

• Clinical Social Worker in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.