MEDICARE: ELIZABETH ANN MACKENZIE MS

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
1	101YM0800X	Mental Health Counselor	18867	FL

General Provider Information

NPI Number	:	1215398458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN MACKENZIE MS

Provider Business Mailing Address
First Line	:	551 SW DUVAL AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-2423
Country	:	US
Telephone Number	:	177-220-1199
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 SW MARTIN DOWNS BLVD
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2815
Country	:	US
Telephone Number	:	772-254-4347
Fax Number	:	772-212-8462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2016
Last Update Date	:	10/08/2025

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