Alicia McKenzie, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 9049 Issued in FL

Practice address

1013 Enon CT
St Augustine, FL 32092-0431

Phone

(904) 940-4795

NPI assigned

Oct 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Holistic in Home Support Services, LLC

  • Adult Companion
  • St Augustine, FL
  • NPI 1194950329
  NPD (past) Authorized official
• Holistic Speech Therapy Services

  • Speech-Language Pathologist
  • St Augustine, FL
  • NPI 1043547284
  NPD (past) Authorized official

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1891948469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 ENON CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920431",
            "telephone_number": "904-940-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 ENON CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920431",
            "telephone_number": "904-940-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ALICIA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 9049",
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000828900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001689700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylee Elizabeth McHone
• Anna McIntyre, DPT
• Patricia M McIntyre
• Brittany McKay, M.S., CCC-SLP
• Sevanista D McKee, APRN
• Mark Daniel McKenzie
• Thomas Edward McKenzie, D.O.
• Hailey Wilson McKinley, DDS, MSD
• Joseph Matthew McKinley, M.D.
• Kim McKinney, OT/PT

• Speech-Language Pathologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.