Healthcare Provider Details

I. General information

NPI: 1518546076
Provider Name (Legal Business Name): MACKENZIE BURNS LPCC, LPC-MH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7434 S LOUISE AVE # C203
SIOUX FALLS SD
57108-5955
US

IV. Provider business mailing address

420 S HENRY ST
PIERRE SD
57501-4515
US

V. Phone/Fax

Practice location:
  • Phone: 712-209-1703
  • Fax:
Mailing address:
  • Phone: 605-494-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: