Provider Demographics
NPI:1063838597
Name:MCKENZIE & ASSOCIATES LLC
Entity Type:Organization
Organization Name:MCKENZIE & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMFT
Authorized Official - Phone:316-351-7644
Mailing Address - Street 1:300 N MAIN ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1525
Mailing Address - Country:US
Mailing Address - Phone:316-351-7644
Mailing Address - Fax:316-351-7689
Practice Address - Street 1:300 N MAIN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-1525
Practice Address - Country:US
Practice Address - Phone:316-351-7644
Practice Address - Fax:316-351-7689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS859106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty