Kathleen Chamisa Mackenzie, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801097665 Issued in MI

Practice address

202 E Washington St Ste 401
Ann Arbor, MI 48104-2017

Phone

(734) 926-8162

NPI assigned

Feb 13, 2017

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chamisa Mackenzie, LMSW, LLC

  • Adult Mental Health Clinic/Center
  • Ann Arbor, MI
  • NPI 1720586597
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1831638659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 401",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-926-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 401",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-926-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "KATHLEEN",
        "middle_name": "CHAMISA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "6801097665",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Mack
• Kelly Mack
• Megan Rose Mack, M.D.
• Heather Mary Mackenzie, LMSW
• Jacob John Mackenzie, PA-C
• Ryan Michael Mackenzie, NP
• Wilma Anne Mackenzie, AGACNP-BC
• Regina Mackiewicz Dailey, D.M.D
• Bianca Lynne Mackiewicz, LMSW
• Laura Lynne Mackimmie

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

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