Mackenna Marie Minehan, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095993 Issued in NY

Practice address

325 W 89TH St Apt 7
New York, NY 10024-2166

Phone

(858) 531-5673

Fax

(858) 531-5673

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mackenna Rucci Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Susan Soderman Family Counseling, Inc.

  • Marriage & Family Therapist
  • Santa Barbara, CA
  • NPI 1134983232

  Multi-Specialty

  NPD (past)
• The Openminds Foundation

  • Clinical Psychologist
  • Santa Barbara, CA
  • NPI 1679266910
  NPD (past)

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1750809000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233203",
            "telephone_number": "858-531-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W 89TH ST APT 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242166",
            "telephone_number": "858-531-5673",
            "fax_number": "858-531-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINEHAN",
        "first_name": "MACKENNA",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENNA",
            "last_name": "RUCCI",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine Ann Mindolovich, PH.D.
• Mindset Health Inc
• Mindset Psychiatric Services PLLC
• Mindspan Medical America PA
• Mindwell Psychology Nyc PLLC
• Janna Claire Minehart, MD
• Mia Minen, MD MPH
• Johnetta Miner, NP
• Ana Christina E. Minerly, PH.D.
• Jennifer Minerva

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.