Martha Ann Mackenzie, PH.D, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00005652 Issued in WA

Practice address

16150 NE 85TH St Ste 222
Redmond, WA 98052-3546

Phone

(425) 869-6687

Fax

(877) 880-4388

NPI assigned

Mar 4, 2008

Last updated

Mar 4, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Wellspring Family Services

  dba Wellspring

  • Case Management Agency
  • Seattle, WA
  • NPI 1093740573
  NPD (past)

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1598935603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 NE 85TH ST STE 222",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523546",
            "telephone_number": "425-869-6687",
            "fax_number": "877-880-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16150 NE 85TH ST STE 222",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523546",
            "telephone_number": "425-869-6687",
            "fax_number": "877-880-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "MARTHA",
        "middle_name": "ANN",
        "credential": "PH.D, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Lyons, LMHC
• John Paul Lytle Jr., M.D.
• Samuel Alexander Macario, OT
• Stephanie A Mack Harmon
• Shelley L. Mackaman, PH.D.
• Lisa Mackey
• Megan Elizabeth Macmurray, D.D.S.
• Maureen Patricia Madden, PT
• Hunter Park Madich, DPT
• Bryia Madison

• Clinical Social Worker in Redmond, WA
• Providers in Redmond, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.