Jacqueline McKenzie, M.A.S.M., L.S.W.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

.943876 Issued in OH

Practice address

24 Glenwood Ave
Dayton, OH 45405-3831

Phone

(937) 814-3573

Fax

(937) 715-4407

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. J. McKenzie'S Professional Consultants Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1942382841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 BROADBUSH DR",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454261905",
            "telephone_number": "937-251-7444",
            "fax_number": "937-715-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GLENWOOD AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454053831",
            "telephone_number": "937-814-3573",
            "fax_number": "937-715-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "M.A.S.M., L.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0014444",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": ".943876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "MCKENZIE'S PROFESSIONAL CONSULTANTS",
            "prefix": "MS.",
            "credential": "L.I.C.D.C., I.C.D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessica Patricia McKelvey
• David Stephen McKenna, MD
• Patrick McKenna
• Ashley McKenzie, RN
• Chelsey McKenzie
• Linda McKenzie, RN
• Lauren McKey
• Amanda L McKibben, ATC
• Amy Hinshaw McKinley, MA, LPCA
• Hillary J McKinley

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.