Provider Demographics
NPI:1912024118
Name:MCKENZIE, AMY (LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9270 BAY PLAZA BLVD STE 614
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4450
Mailing Address - Country:US
Mailing Address - Phone:813-944-2268
Mailing Address - Fax:813-944-2269
Practice Address - Street 1:9270 BAY PLAZA BLVD STE 614
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4450
Practice Address - Country:US
Practice Address - Phone:813-944-2268
Practice Address - Fax:813-944-2269
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health