Individual provider Active NPI

Mackenzie Bernal

  • Marriage & Family Therapist
  • Maitland, FL
National Provider Identifier
1760071583
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMT4541 Issued in FL
Practice address
533 Versailles Dr Ste 200
Maitland, FL 32751-7303
Phone
(407) 308-0345
NPI assigned
Jan 15, 2021
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMT4541 FL Primary

Addresses

Primary practice location

533 Versailles Dr Ste 200
Maitland, FL 32751-7303

Mailing address

3900 Southpointe Dr Apt 117
Orlando, FL 32822-3719
Phone (407) 488-2588

Other practice location 1

7758 Wallace Rd Ste 1
Orlando, FL 32819-7217
Phone (407) 592-8997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1760071583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 SOUTHPOINTE DR APT 117",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328223719",
            "telephone_number": "407-488-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 VERSAILLES DR STE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517303",
            "telephone_number": "407-308-0345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7758 Wallace Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197217",
            "country_code": "US",
            "telephone_number": "407-592-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "MACKENZIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.