Mackenzie Lea Kerber, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01236 Issued in MN

Practice address

3464 Washington Dr Ste 115
Eagan, MN 55122-1453

Phone

(651) 348-8551

Fax

(651) 409-2029

NPI assigned

Jul 11, 2016

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

• Mackenzie Lea Shiell Former name

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.

• Eagan Psychotherapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eagan, MN
  • NPI 1518501584
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1831541168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 WASHINGTON DR STE 115",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221453",
            "telephone_number": "651-348-8551",
            "fax_number": "651-409-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 WASHINGTON DR STE 115",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221453",
            "telephone_number": "651-348-8551",
            "fax_number": "651-409-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBER",
        "first_name": "MACKENZIE",
        "middle_name": "LEA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "SHIELL",
            "middle_name": "LEA",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey Kelly, CNP
• Kenn Folks Home Care Services LLC
• Kenn Folks Personal Care Agency LLC
• Brian Kennedy
• Lauren Kennerly
• Mark Patrick Kerekes, MD
• Jacob Michael Kerkering, DDS
• Justin Adam Kertis, DPT
• Kathleen Kelly Key, D.D.S.
• Ciera Shanaye Keyes

• Mental Health Counselor in Eagan, MN
• Providers in Eagan, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.