Mackenzie Harris

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4377-125 Issued in WI

Legal business name

MACKENZIE HARRIS

Practice address

6789 N Green Bay Ave
Glendale, WI 53209

Phone

(414) 292-3900

NPI assigned

Aug 14, 2012

Last updated

Aug 14, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mackenzie Harris, PHD

Title

Psychologist

Phone

(414) 455-3125

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1790032316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 13214",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532130214",
            "telephone_number": "414-455-3125",
            "fax_number": "262-654-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6789 N GREEN BAY AVE",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-292-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKENZIE HARRIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "414-455-3125",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4377-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.