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NPI Code Detail

MEDICARE: MS. STACY ANN MCKENZIE LPC

MEDICARE:  MS. STACY ANN MCKENZIE  LPC
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
1101YM0800XMental Health Counselor5153757-6004UT
2101YP2500XProfessional Counselor5153757-6004UT

General Provider Information

NPI Number : 1568559110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STACY ANN MCKENZIE LPC
Provider Business Mailing Address
First Line : 2416 SEGO LILY DR
Second Line :
City : SANDY
State : UT
Zip : 84092-4435
Country : US
Telephone Number : 801-942-3603
Fax Number :
Provider Business Practice Location Address
First Line : 5800 HIGHLAND DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-1359
Country : US
Telephone Number : 801-272-9980
Fax Number : 801-272-9976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 09/11/2025

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Directions to “ MS. STACY ANN MCKENZIE LPC” Practice Location

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