Individual provider Active NPI

Mackenzie Taylor Rice

  • Psychologist
  • Fort Wayne, IN
National Provider Identifier
1871019844
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20043940A Issued in IN
Practice address
6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583
Phone
(260) 432-0066
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39004077A IN
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 20043940A IN Primary
Health Service Psychologist 103TH0100X 20043940B IN

Addresses

Primary practice location

6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583

Mailing address

6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583

Other practice location 1

105 Enterprise Dr
Warsaw, IN 46580-1204
Phone (574) 268-0448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20240205002387 IN Practitioner - Mental Health Counselor 2668815861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeworks Counseling and Consulting, Inc.Group PAC ID 6204986573, 7 clinicians

Practice addresses (Care Compare)

6202 Constitution Dr
Suite D
Fort Wayne, IN 46804-1583
Phone 2604320066301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39004077AINMDMental Health Counselor
20043940AINMDPsychologist
20043940BINMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeworks Counseling & Consulting, Inc. CurrentSince Aug 22, 2024 Accepting new patients

Locations

6202 Constitution Dr
Ste D
Fort Wayne, IN 46804
Phone (260) 432-0066

1601 I St
La Porte, IN 46350
Phone (574) 268-0448

105 Enterprise Dr
Warsaw, IN 46580
Phone (574) 268-0448

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1871019844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 CONSTITUTION DR STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 CONSTITUTION DR STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041583",
            "telephone_number": "260-432-0066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465801204",
            "country_code": "US",
            "telephone_number": "574-268-0448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICE",
        "first_name": "MACKENZIE",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004077A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043940A",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20043940B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.