Michael William Vincent Mackie, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30000 Issued in CA

Practice address

10700 Santa Monica Blvd Ste 300
Los Angeles, CA 90025-6587

Phone

(424) 465-2840

NPI assigned

May 10, 2018

Sex

Male

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 CA

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 Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Michael W Mackie PHD a Professional Corp

  • Forensic Psychologist
  • Los Angeles, CA
  • NPI 1174385892
  Medicare reassignment NPD Authorized official
• Memory Check Psychological Services, a Professional Corporation

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1912184219
  Medicare reassignment NPD

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1851881379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256587",
            "telephone_number": "424-465-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM VINCENT",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Rae Mackey, OTR/L
• Robert Neil Mackey, CERTIFIED COUNSELOR
• Sharon Mackey
• Thomas Mackey
• Juaquina Mackie
• Karen Macklin, AMFT
• Oteka Macklin, B.A.
• Fox Eros Maclachlan, MA, AMFT
• Shannon J Maclaren, LCSW
• Molly Maclean

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.