McKziel Clinic Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP1413 Issued in MN

Legal business name

MCKZIEL CLINIC INC

Practice address

287 Marschall Rd
Suite 204
Shakopee, MN 55379-1686

Phone

(952) 445-7430

Fax

(952) 445-7430

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Creighton John McKowen, LP

Title

Owner

Phone

(952) 445-7430

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487794194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 MARSCHALL RD",
            "address_2": "SUITE 204",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791686",
            "telephone_number": "952-445-7430",
            "fax_number": "952-445-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 MARSCHALL RD",
            "address_2": "SUITE 204",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791686",
            "telephone_number": "952-445-7430",
            "fax_number": "952-445-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKZIEL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKOWEN",
        "authorized_official_first_name": "CREIGHTON",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-445-7430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "61-15251",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30505MC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Margaret McAndrew
• Nanette Evelyn McDevitt, PSY.D.
• McGraw Chiropractic Clinic PA.
• Daniel John McGraw, DC
• Holly Joelle McKinley, PSYD
• Maria Theresa Spartz McLinn
• Holly Marie McMahon, DDS
• Kyle McNett
• Elizabeth Islay McPeek, MSW, LICW, LCSW
• Tania Mejia

• Psychologist in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.