Provider Demographics
NPI:1538500269
Name:WILLIAMS, MCKENZIE LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:WILLIAMS
Other - Last Name:NINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4568 S. HIGHLAND DR.
Mailing Address - Street 2:#380
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84117
Mailing Address - Country:US
Mailing Address - Phone:801-864-2981
Mailing Address - Fax:
Practice Address - Street 1:4568 S. HIGHLAND DR.
Practice Address - Street 2:#380
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84117
Practice Address - Country:US
Practice Address - Phone:801-864-2981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6074639-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical