Olivia Margaret Dorothy Mackley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3692 Issued in MN

Practice address

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Phone

(612) 871-1454

Fax

(612) 871-1505

NPI assigned

Feb 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Catalyst Insight Collective, LLC

  • Mental Health Counselor
  • St Anthony, MN
  • NPI 1619562113
  Medicare reassignment
• Allina Health System

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1346282563
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Washburn Center for Children

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1225136419
  NPD (past)

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1770116691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLEY",
        "first_name": "OLIVIA",
        "middle_name": "MARGARET DOROTHY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "3692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Mackenthun, MD
• Terra R Mackenthun, RN, MSN
• Paula S Mackey, MD
• Katherine A Mackin, LICSW
• Sharon Mackinnon
• Suzanne Lynn Mackley, SLP-R, CCC
• Makenze Maggie Mackovich, MENTAL HEALTH P
• Danielle Yvonne Maclaurin, APRN,BC, ANP, GNP
• Douglas G Maclean, MD
• Skyler Maclean, PHARMD

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.