Mackensie Marie Keiner, MSW, CSWA, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A4749 Issued in OR

Practice address

12725 SW Millikan Way Ste 300
Beaverton, OR 97005-1687

Phone

(503) 713-5040

Fax

(503) 713-5050

NPI assigned

Sep 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Restoring Balance LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaverton, OR
  • NPI 1003441536
  NPD Authorized official

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1497274641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 NW 118TH AVE UNIT 106",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296670",
            "telephone_number": "503-816-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 SW MILLIKAN WAY STE 300",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051687",
            "telephone_number": "503-713-5040",
            "fax_number": "503-713-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEINER",
        "first_name": "MACKENSIE",
        "middle_name": "MARIE",
        "credential": "MSW, CSWA, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "A4749",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "A4749",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A4749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500732074",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brigette Marie Keane, MFT
• Dylan Kearl
• Emma K Keefe
• Lindsay Keefner, APC
• Helen E Keene
• Keith R Larson DMD PC
• Tyler Keliiheleua, N.D.
• Bridget Keller
• David Larsen Keller, DMD
• Stephanie Michelle Keller

• Clinical Social Worker in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Clinical Social Worker in Oregon

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