Active NPI
Candace McKenzie, LMHC L60304682
- Mental Health Counselor
- Bremerton, WA
National Provider Identifier
1962025114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- L60304682
- Practice address
- 2564 Cascades Pass Blvd
The Landings BLDG. 779
Bremerton, WA 98312 - Phone
- (360) 476-8666
- NPI assigned
- May 22, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | L60304682 | WA | Primary |
Addresses
Primary practice location
2564 Cascades Pass Blvd
The Landings BLDG. 779
Bremerton, WA 98312
Mailing address
1790 Sidney Ave Apt 3-112
Port Orchard, WA 98366-2462
Phone (425) 466-8207
Other practice location 1
1141 U St
Bremerton, WA 98314-0001
Phone (360) 627-2974
Other practice location 2
2902 Ohio St
Silverdale, WA 98315-2907
Phone (360) 396-5920
Other practice location 3
2903 Ohio St
Silverdale, WA 98315-2907
Phone (360) 396-2463
Other practice location 4
6180 Snoqualmie Pass St.
Bremerton, WA 98312
Phone (360) 627-2041
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 |
|---|---|---|---|
| L60304682 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1962025114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 SIDNEY AVE APT 3-112",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983662462",
"telephone_number": "425-466-8207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2564 CASCADES PASS BLVD",
"address_2": "THE LANDINGS BLDG. 779",
"city": "BREMERTON",
"state": "WA",
"postal_code": "98312",
"telephone_number": "360-476-8666"
}
],
"practiceLocations": [
{
"address_1": "1141 U St",
"address_purpose": "LOCATION",
"city": "Bremerton",
"state": "WA",
"postal_code": "983140001",
"country_code": "US",
"telephone_number": "360-627-2974",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2902 Ohio St",
"address_purpose": "LOCATION",
"city": "Silverdale",
"state": "WA",
"postal_code": "983152907",
"country_code": "US",
"telephone_number": "360-396-5920",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2903 Ohio St",
"address_purpose": "LOCATION",
"city": "Silverdale",
"state": "WA",
"postal_code": "983152907",
"country_code": "US",
"telephone_number": "360-396-2463",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6180 Snoqualmie Pass St.",
"address_purpose": "LOCATION",
"city": "Bremerton",
"state": "WA",
"postal_code": "98312",
"country_code": "US",
"telephone_number": "360-627-2041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENZIE",
"first_name": "CANDACE",
"credential": "LMHC L60304682",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-22",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "L60304682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.