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NPI Code Detail

MEDICARE: MACKENZIE J MILLER

MEDICARE: MACKENZIE J MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLMHC10002785MA

General Provider Information

NPI Number : 1033962402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE J MILLER
Provider Business Mailing Address
First Line : 907 ADAMS ST # 2
Second Line :
City : BOSTON
State : MA
Zip : 02124-5209
Country : US
Telephone Number : 857-250-9962
Fax Number :
Provider Business Practice Location Address
First Line : 190 LENOX ST
Second Line :
City : NORWOOD
State : MA
Zip : 02062-3416
Country : US
Telephone Number : 781-769-8674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2024
Last Update Date : 03/11/2026

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Directions to “ MACKENZIE J MILLER ” Practice Location

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