Individual provider Active NPI

Mackenzie Stoll, LPCC

  • Mental Health Counselor
  • Wooster, OH
National Provider Identifier
1689145815
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2202888 Issued in OH
Practice address
2685 Armstrong Rd
Wooster, OH 44691-9041
Phone
(330) 345-7949
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1902359 OH
Mental Health Counselor 101YM0800X E.2202888 OH Primary

Addresses

Primary practice location

2685 Armstrong Rd
Wooster, OH 44691-9041

Mailing address

2685 Armstrong Rd
Wooster, OH 44691-9041
Phone (330) 345-7949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240919003485 OH Practitioner - Mental Health Counselor 5193266989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1902359OHMDMental Health Counselor
E.2202888OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Children's Home of Ohio CurrentSince Jun 22, 2021 Accepting new patients
Cornerstone Pathways, LLC Mental Health CurrentSince Jul 26, 2024 Accepting new patients
Christian Children's Home of Ohio CurrentSince Aug 16, 2020 Accepting new patients

Locations

508 Dickson St
Ste 2
Wellington, OH 44090
Phone (440) 647-2225

2685 Armstrong Rd
Wooster, OH 44691
Phone (330) 345-7949

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/cchoo/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1689145815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 ARMSTRONG RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919041",
            "telephone_number": "330-345-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 ARMSTRONG RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919041",
            "telephone_number": "330-345-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLL",
        "first_name": "MACKENZIE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1902359",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2202888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.