Dedre Ameigan Mackie

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

308 12TH Ave S
Buffalo, MN 55313-2321

Phone

(763) 682-4400

Fax

(763) 682-1353

NPI assigned

Oct 6, 2008

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

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1679724934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 13TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032613",
            "telephone_number": "320-252-5010",
            "fax_number": "320-203-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 12TH AVE S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132321",
            "telephone_number": "763-682-4400",
            "fax_number": "763-682-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "DEDRE",
        "middle_name": "AMEIGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lukas Lawrence Lynch, PHARMD
• Peter R Lynch, DDS
• Alex Macalena Jr., LP
• Elaine Macalena, LPT
• Erin Macheel, PA-C
• Rebecca Renee Mades, FNP
• Myrna Lee Magandy
• Kristin Mae Mahlstedt, LPN
• Mangas Family Chiropractic PLLC
• Corey L Martin, MD

• Mental Health Counselor in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.