Individual provider Active NPI

Jenna Mackenzie, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Philadelphia, PA
National Provider Identifier
1558714337
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL016316 Issued in PA
Practice address
1101 Chestnut St FL 16
Philadelphia, PA 19107-3612
Phone
(215) 955-6760
NPI assigned
Jul 18, 2016
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 111874 TX
Speech-Language Pathologist 235Z00000X SL016316 PA Primary
Speech-Language Pathologist 235Z00000X 41YS01348300 NJ

Addresses

Primary practice location

1101 Chestnut St FL 16
Philadelphia, PA 19107-3612

Mailing address

7400 Merton Minter St
Speech Pathology and Audiology Dept
San Antonio, TX 78229-4404
Phone (210) 617-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
111874TXMDOccupational Therapist
41YS01348300NJMDSpeech-Language Pathologist
SL016316PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1558714337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "address_2": "SPEECH PATHOLOGY AND AUDIOLOGY DEPT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST FL 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "JENNA",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111874",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL016316",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01348300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.