Individual provider Active NPI

McKenzie Clair Carpenter, LMFT

  • Marriage & Family Therapist
  • Grinnell, IA
National Provider Identifier
1417662974
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
080978 Issued in IA
Practice address
818 4TH Ave
Grinnell, IA 50112-2041
Phone
(641) 236-1644
NPI assigned
Jan 19, 2023
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 080978 IA Primary

Addresses

Primary practice location

818 4TH Ave
Grinnell, IA 50112-2041

Mailing address

818 4TH Ave
Grinnell, IA 50112-2041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231220000930 IA Practitioner - Marriage and Family Therapist 3870943699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rodasi LLC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

818 4th Ave
Grinnell, IA 50112
Phone (641) 236-1644

684 S Barrington Rd
Streamwood, IL 60107
Phone (630) 883-0815

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1417662974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122041",
            "telephone_number": "641-236-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MCKENZIE",
        "middle_name": "CLAIR",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "080978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

Verify at the official NPI Registry.