Mary Lynne Mack, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2598-057 Issued in WI

Practice address

5635 N Scottsdale Rd Ste 170
Scottsdale, AZ 85250-5945

Phone

(480) 737-6076

NPI assigned

Jul 12, 2006

Last updated

Mar 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 Psychologist

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Mary Lynne Mack PHD LLC

  • Clinical Psychologist
  • Phoenix, AZ
  • NPI 1639415078
  Medicare reassignment Authorized official
• Lakefront Wellness Center, SC

  • Clinical Psychologist
  • Pewaukee, WI
  • NPI 1316024847
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774742400000",
    "number": "1700811015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 N SIERRA VISTA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852881462",
            "telephone_number": "480-737-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 N SCOTTSDALE RD STE 170",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852505945",
            "telephone_number": "480-737-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MARY",
        "middle_name": "LYNNE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-03-29",
        "certification_date": "2026-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PSY-005478",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2598-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Alfonso Macias-Sarabia, LPC
• Elizabeth Martha Macias
• Elizabeth Macisaac, BSN, RN, MMCP
• Zoe Marie Macisaac, M.D.
• Kerry Mack, M.S., SLP
• Samantha Mack
• Cheryl Mackechnie, MD
• Hugh L. Mackechnie, M.D.
• Danielle Mackelprang, NP-C
• Martha Mayella Mackesy, FNP-C

• Psychologist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2026; 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.