McKenzie Broekstra, LSW; LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LSW.0009922840 Issued in CO

Practice address

6 Anyhow LN
Gansevoort, NY 12831-1710

Phone

(616) 446-3126

NPI assigned

Oct 11, 2020

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

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Services North, Inc.Group PAC ID 3173511557, 68 clinicians

Practice addresses (Care Compare)

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.

• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morrisonville, NY
  • NPI 1689621468
  Medicare reassignment Care Compare group NPD
• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queensbury, NY
  • NPI 1447005541
  NPD

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

{
    "created_epoch": "1602374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1790383966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ANYHOW LN",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128311710",
            "telephone_number": "616-446-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ANYHOW LN",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128311710",
            "telephone_number": "616-446-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEKSTRA",
        "first_name": "MCKENZIE",
        "credential": "LSW; LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-11",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.0009922840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Michelle Austin, MD
• Deepak H Bakhru, DDS
• Jacqueline Nicolette Battista, PA
• Richard Boehler, MD
• Carrie L Braun
• Lorraine L Bruce, LPN
• Jacquelyn A Buckley, PA-C
• Nicole Marie Byrne, DMD
• Lisa Marie Cartier, CERTIFIED DOULA
• Lindsay Castiglione, IBCLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.