Organization Active NPI

McKenzie Mental Health, LLC

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1750102075
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MCKENZIE MENTAL HEALTH, LLC
Practice address
921 Country Club Rd Ste 100
Eugene, OR 97401-6039
Phone
(458) 214-8745
NPI assigned
Oct 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Kevin Kelley, LPCNPI 1700394558
Title
Managing Member
Phone
(458) 205-8347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

921 Country Club Rd Ste 100
Eugene, OR 97401-6039

Mailing address

921 Country Club Rd Ste 100
Eugene, OR 97401-6039
Phone (458) 205-8347

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250203001522 OR Part B Supplier - Clinic/Group Practice 4183153364 Receives reassigned benefits from 5 practitioners
Practice locations: Eugene, OR

National Provider Directory

National Provider Directory

Locations

921 Country Club Rd
Ste 100
Eugene, OR 97401
Phone (458) 205-8347

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1750102075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 COUNTRY CLUB RD STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016039",
            "telephone_number": "458-205-8347",
            "fax_number": "458-231-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 COUNTRY CLUB RD STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016039",
            "telephone_number": "458-214-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-19",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "458-205-8347",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.