Healthcare Provider Details

I. General information

NPI: 1750952065
Provider Name (Legal Business Name): MACKENZIE ELAINE ABNEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 N MICHIGAN RD STE 240
ZIONSVILLE IN
46077-7845
US

IV. Provider business mailing address

6195 SCHOOLER DR APT 104
WHITESTOWN IN
46075-6604
US

V. Phone/Fax

Practice location:
  • Phone: 812-247-8010
  • Fax:
Mailing address:
  • Phone: 765-376-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010629A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: