Individual provider Active NPI

Mackenzie Lee Westermeyer, LICSW

  • Clinical Social Worker
  • Ortonville, MN
National Provider Identifier
1972118008
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23014 Issued in MN
Practice address
28 2ND St NW
Ortonville, MN 56278-1407
Phone
(320) 839-8322
Fax
(855) 867-8780
NPI assigned
Sep 15, 2020
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 23014 MN Primary

Addresses

Primary practice location

28 2ND St NW
Ortonville, MN 56278-1407

Mailing address

627 Otto Ave
Ortonville, MN 56278-1168
Phone (320) 305-0645

Other practice location 1

1234 E Highway 7
Montevideo, MN 56265-1705
Phone (320) 269-6581 ext. 9213

Other practice location 2

1125 6th St SE
Willmar, MN 56201-4675
Phone (320) 235-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20201123000140 MN Practitioner - Clinical Social Worker 7113338245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Dakota School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23014MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Centers CurrentSince Aug 31, 2020 Accepting new patients

Locations

1234 E Highway 7
Montevideo, MN 56265
Phone (320) 269-6412

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1972118008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 OTTO AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781168",
            "telephone_number": "320-305-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 2ND ST NW",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781407",
            "telephone_number": "320-839-8322",
            "fax_number": "855-867-8780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 E Highway 7",
            "address_purpose": "LOCATION",
            "city": "Montevideo",
            "state": "MN",
            "postal_code": "562651705",
            "country_code": "US",
            "telephone_number": "320-269-6581 x9213",
            "fax_number": "855-562-7905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1125 6th St SE",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "562014675",
            "country_code": "US",
            "telephone_number": "320-235-4613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTERMEYER",
        "first_name": "MACKENZIE",
        "middle_name": "LEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ortonville, MN

Sources for this page

Verify at the official NPI Registry.