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NPI Code Detail

MEDICARE: MADISON ELIZABETH MCKENZIE LCSW

MEDICARE: MADISON ELIZABETH MCKENZIE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker252947KY
21041C0700XClinical Social Worker255476KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134635774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON ELIZABETH MCKENZIE LCSW
Provider Business Mailing Address
First Line : 615 ELSINORE PL STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1459
Country : US
Telephone Number : 513-834-7063
Fax Number : 513-873-1567
Provider Business Practice Location Address
First Line : 1030 MONARCH ST STE 100
Second Line :
City : LEXINGTON
State : KY
Zip : 40513-1820
Country : US
Telephone Number : 216-468-5000
Fax Number : 216-456-8128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2017
Last Update Date : 09/12/2023

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Directions to “ MADISON ELIZABETH MCKENZIE LCSW” Practice Location

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