Provider Demographics
NPI:1760629190
Name:MCKENZIE, MAUREEN AGNES (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:AGNES
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SOUTH STEELE, SUITE 840
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-780-9340
Mailing Address - Fax:303-388-4601
Practice Address - Street 1:50 S STEELE ST STE 840
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2841
Practice Address - Country:US
Practice Address - Phone:303-780-9340
Practice Address - Fax:303-388-4601
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO876-4401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical