Healthcare Provider Details

I. General information

NPI: 1295647162
Provider Name (Legal Business Name): MACKENZIE STRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 PENBROOKE DR STE 1&2
PENFIELD NY
14526-2021
US

IV. Provider business mailing address

33 FARM FIELD LN
PITTSFORD NY
14534-2863
US

V. Phone/Fax

Practice location:
  • Phone: 585-204-2172
  • Fax:
Mailing address:
  • Phone: 585-752-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018423-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: