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Kathleen Chamisa Mackenzie

Social Worker

Behavioral Health & Social Service Providers

202 E Washington St Ste 401, Ann Arbor, MI 48104-2017

PECOS Enrollment

This provider is enrolled in PECOS as KATHLEEN MACKENZIE.

Based on the most recent information from CMS, provider Kathleen Chamisa Mackenzie is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1831638659
Provider Type
Individual
Full Name
Mackenzie, Kathleen Chamisa
Credential
MSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/13/2017
Last Updated
9/14/2021

Contact Information

Practice Location

202 E Washington St Ste 401, Ann Arbor, MI 48104-2017

(734) 926-8162

Unlisted Fax

Mailing Location

202 E Washington St Ste 401, Ann Arbor, MI 48104-2017

(734) 926-8162

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801097665 Michigan
Code 261QM0850X	Description Clinic/Center Ambulatory Health Care Facilities	License 6801097665 Michigan

Kathleen Chamisa Mackenzie

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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