Provider Demographics
NPI:1225729403
Name:CARY, MCKENZIE (LMSW)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:CARY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:SALAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10342 E EMELITA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-7231
Mailing Address - Country:US
Mailing Address - Phone:480-365-9344
Mailing Address - Fax:
Practice Address - Street 1:10342 E EMELITA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-7231
Practice Address - Country:US
Practice Address - Phone:480-365-9344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ164941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical