Kenneth Mackie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7080 Issued in OR

Practice address

4185 SW Research Way
Corvallis, OR 97333-1783

Phone

(541) 766-6767

Fax

(541) 766-6186

NPI assigned

Jan 30, 2012

Sex

Male

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

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Benton County

  • Case Management Agency
  • Corvallis, OR
  • NPI 1952053522
  NPD
• Ken Mackie, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corvallis, OR
  • NPI 1780521633
  NPD
• Benton County

  • Federally Qualified Health Center (FQHC)
  • Corvallis, OR
  • NPI 1932161361
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1619249158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973390579",
            "telephone_number": "541-766-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4185 SW RESEARCH WAY",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331783",
            "telephone_number": "541-766-6767",
            "fax_number": "541-766-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "KENNETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Macdonald
• Rebecca Macdow, OD
• Kate Macer, PT, DPT
• Karen L Macewan, MD
• Ricardo Antonio Machuca
• Marley Anne Mackin
• Marcia Macomber
• Aditi Madabhushi, M.D
• Kimberly Madden, LPN
• Troy Maddux, L.M.T.

• Clinical Social Worker in Corvallis, OR
• Providers in Corvallis, 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 Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.