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General NPI Number Information
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NPI Number | 1366019937
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Entity Type | Individual
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Provider Name | MACKENZIE ESSON LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 625 3RD AVE NW
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City | FARIBAULT
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State | MN
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Zip | 55021-4219
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Country | US
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Telephone | 763-780-3307
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Fax | 763-780-3306
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Provider Business Mailing Address
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Address Line | 1551 PAYNE AVE
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City | SAINT PAUL
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State | MN
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Zip | 55130-3218
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Country | US
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Telephone | 763-780-3307
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Fax | 763-780-3306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC05162
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License Number State | MN
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