Healthcare Provider Details

I. General information

NPI: 1528983046
Provider Name (Legal Business Name): MACKENZI BERNER MASTER'S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

IV. Provider business mailing address

55 BANK ST
WHITE PLAINS NY
10606-1921
US

V. Phone/Fax

Practice location:
  • Phone: 914-525-4634
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: