Individual provider Active NPI

Mackenzie Anne Halker, LCSW-R

  • Clinical Social Worker
  • Lockport, NY
National Provider Identifier
1750463097
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069739-1 Issued in NY
Practice address
405 Bewley Building
Lockport, NY 14094-2934
Phone
(716) 266-2914
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R069739-1 NY Primary

Addresses

Primary practice location

405 Bewley Building
Lockport, NY 14094-2934

Mailing address

10 Kingston Cir
Lockport, NY 14094-5606
Phone (716) 266-2914

Other identifiers 1

IdentifierTypeStateIssuer
00069739-1MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100702000131 NY Practitioner - Clinical Social Worker 4688705866 Practice locations: Lockport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Kingston Cir
Lockport, NY 14094-5606

397 Davison Rd
Suite 1
Lockport, NY 14094-4005
Phone (716) 266-2914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R069739-1NYMDClinical Social Worker
069739NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1750463097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KINGSTON CIR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945606",
            "telephone_number": "716-266-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BEWLEY BUILDING",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140942934",
            "telephone_number": "716-266-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALKER",
        "first_name": "MACKENZIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069739-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00069739-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.