Individual provider Active NPI

Makenzi Marlene Gregory, LMHC

  • Mental Health Counselor
  • Puyallup, WA
National Provider Identifier
1992254254
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61489046 Issued in WA
Practice address
325 E Pioneer
Puyallup, WA 98372-3265
Phone
(253) 697-8400
Fax
(253) 697-3730
NPI assigned
Sep 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61489046 WA Primary

Addresses

Primary practice location

325 E Pioneer
Puyallup, WA 98372-3265

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other names 1

  • Makenzi Marlene York Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240123004370 WA Practitioner - Mental Health Counselor 5799137949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 445-8120

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH61489046WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 1, 2024 Accepting new patients
Multicare Health System CurrentSince Jan 1, 2024 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

325 E Pioneer
Puyallup, WA 98372
Phone (253) 445-8120

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1992254254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "MAKENZI",
        "middle_name": "MARLENE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61489046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKENZI",
            "last_name": "YORK",
            "middle_name": "MARLENE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.