Mackenzie Sarah Bentley, LMFT
Individual provider Active NPI Marriage & Family Therapist · Homer, MI
NPI 1861769895 · NPPES record last updated Oct 14, 2020
Key facts
- NPI
- 1861769895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 4101006514 (MI)
- Practice address
- 408 Maple St
Homer, MI 49245-8417 - Phone
- (517) 803-9304
- NPI assigned
- Nov 18, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 21, 2024 through Feb 21, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101006514 | MI | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101006514 | MI | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
408 Maple St
Homer, MI 49245-8417
Mailing address
408 Maple St
Homer, MI 49245-8417
Phone (517) 803-9304
Other practice location 1
3300 Lansing Ave
Jackson, MI 49202-1621
Phone (517) 784-2929
Other providers in Homer, MI
- Kenneth C Adair
- Mark A Booth
- Betsy Carroll Crist
- Dr. Cassidy Kaiser, DC, LLC
- Ella E M Brown Charitable Circle
- Ella E M Brown Charitable Circle
All providers in Homer, MI · Marriage & Family Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.