Marvin McKenzie Jr., LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801071502 Issued in MI

Practice address

2715 Doncaster Ave SW
Wyoming, MI 49509-2024

Phone

(616) 752-0065

NPI assigned

Apr 4, 2007

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 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

Medicare enrollment (NPD)

Enrolled

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.

• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1588935068
  Medicare reassignment NPD
• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD
• Rational Training Consultants

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1285861328
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1932221876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 DONCASTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092024",
            "telephone_number": "616-752-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 DONCASTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092024",
            "telephone_number": "616-752-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "MARVIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801071502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Ann McCune
• Samantha McDaniel, M.S., CCC-SLP
• Angila Marie McEwen, RN
• Mark McKamey, ATC
• Shawn Pauline McKenna
• William Patrick McKeown, D.O.
• Emily McKerchie, D.O.
• Allison McLaughlin, D.O.
• Brooke McNamara
• Michael W McNamara, M.D.

• Clinical Social Worker in Wyoming, MI
• Providers in Wyoming, 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 Jul 26, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.