Active NPI
Mackenzie Stickney, LMFT
- Marriage & Family Therapist
- Chaska, MN
National Provider Identifier
1932826435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3920
- Practice address
- 1107 Hazeltine Blvd Ste 300
Chaska, MN 55318-1065 - Phone
- (855) 775-7440
- NPI assigned
- Oct 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | 3920 | MN | Primary |
Addresses
Primary practice location
1107 Hazeltine Blvd Ste 300
Chaska, MN 55318-1065
Mailing address
1107 Hazeltine Blvd Ste 300
Chaska, MN 55318-1065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3920 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1932826435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 HAZELTINE BLVD STE 300",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 HAZELTINE BLVD STE 300",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181065",
"telephone_number": "855-775-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STICKNEY",
"first_name": "MACKENZIE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-25",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.