=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659925865
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAKENZIE HOCH LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2019
-----------------------------------------------------
Last Update Date | 02/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 809 S PATTON RD
-----------------------------------------------------
City | GREAT BEND
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67530-4620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-796-2206
-----------------------------------------------------
Fax | 620-796-2208
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1223
-----------------------------------------------------
City | GREAT BEND
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67530-1223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-796-2206
-----------------------------------------------------
Fax | 620-796-2208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 11417
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------