Healthcare Provider Details

I. General information

NPI: 1730097163
Provider Name (Legal Business Name): MCKENZIE PASCHEN LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S MAIN ST
SOUTH BEND IN
46601-1816
US

IV. Provider business mailing address

1109 E 9TH ST APT 12
ROCHESTER IN
46975-1956
US

V. Phone/Fax

Practice location:
  • Phone: 574-727-1539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88002711A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: