Active NPI
Brooke Danielle McKenzie, LCSW
- Clinical Social Worker
- Somerset, PA
National Provider Identifier
1699947358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW016298
- Practice address
- 224 Twin Lake Rd
Somerset, PA 15501-7727 - Phone
- (814) 443-3639
- Fax
- (814) 443-2737
- NPI assigned
- Apr 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW125414 | PA | |
| Clinical Social Worker | 1041C0700X | CW016298 | PA | Primary |
Addresses
Primary practice location
224 Twin Lake Rd
Somerset, PA 15501-7727
Mailing address
224 Twin Lake Rd
Somerset, PA 15501-7727
Phone (814) 443-3639
Other names 1
- Brooke Danielle Donaldson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW125414 | PA | MD | Social Worker |
| CW016298 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dreamlife Recovery LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Abuse Rehabilitation Facility
- Donegal, PA
- NPI 1316414881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1699947358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 TWIN LAKE RD",
"city": "SOMERSET",
"state": "PA",
"postal_code": "155017727",
"telephone_number": "814-443-3639",
"fax_number": "814-443-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 TWIN LAKE RD",
"city": "SOMERSET",
"state": "PA",
"postal_code": "155017727",
"telephone_number": "814-443-3639",
"fax_number": "814-443-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "BROOKE",
"middle_name": "DANIELLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-02",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW125414",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BROOKE",
"last_name": "DONALDSON",
"middle_name": "DANIELLE",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Somerset, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.