MACKENZIE CARA WILSON (NPI# 1437764735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437764735 |
| Entity Type | Individual |
| Full Name | MACKENZIE CARA WILSON |
| Practice Address |
31 6th St Malone NY 12953-1246 |
| Mailing Address |
1245 County Route 25 Malone NY 12953-6023 |
| Practice Telephone | 5184833261 |
| Practice Fax Number | 5184833383 |
| Mailing Telephone | 5184833261 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376524124 | Mackenzie Paulette Wilson | Pharmacist | Jct Hwy 160 & Nr 35, Hcr 61, Teec Nos Pos, AZ 86514-0000 | 2005-11-09 |
| 1952891780 | Mackenzie Wilson | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-05-17 |
| 1306368337 | Mackenzie Lee Wilson | Speech-Language Pathologist | 151 N Sunrise Ave Ste 1105, Roseville, CA 95661-2931 | 2017-07-11 |
| Street Address |
31 6TH ST |
| City | MALONE |
| State | NY |
| Zip Code | 12953-1246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699727420 | Deceil Leanne Moore | Social Worker | 31 6th St, Malone, NY 12953-1246 | 2006-05-17 |
| 1770182925 | Valerie Meagan | Student in an Organized Health Care Education/Training Program | 31 6th St, Malone, NY 12953-1246 | 2020-10-20 |
| 1982219184 | Brooke Monette | Licensed Practical Nurse | 31 6th St, Malone, NY 12953-1246 | 2020-09-14 |
| 1679187892 | Kallie Ann Villemaire | Student in an Organized Health Care Education/Training Program | 31 6th St, Malone, NY 12953-1246 | 2020-09-04 |
| 1679187801 | Ryan Patrick Shippee | Student in an Organized Health Care Education/Training Program | 31 6th St, Malone, NY 12953-1246 | 2020-09-04 |
| 1598379273 | Gabrielle Yeager | Counselor | 31 6th St, Malone, NY 12953-1246 | 2020-09-01 |
| 1538795653 | Josef E Smith | Social Worker | 31 6th St, Malone, NY 12953-1246 | 2020-03-20 |
| 1104459379 | Philip Todd Horsley | Peer Specialist | 31 6th St, Malone, NY 12953-1246 | 2020-02-17 |
| 1700418266 | Kristen Wren Wade | Social Worker | 31 6th St, Malone, NY 12953-1246 | 2020-02-12 |
| 1386275394 | Valerie Simmons | Interpreter | 31 6th St, Malone, NY 12953-1246 | 2020-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386264356 | Ruth Ann Williamson | Nurse Practitioner | 31 Sixth St., Malone, NY 12953 | 2020-04-20 |
| 1780203760 | Heather Lynn Lauzon | Peer Specialist | 15 Fouth St, Malone, NY 12953 | 2020-04-10 |
| 1245717115 | Darlean James | Family Medicine | 183 Park St Ste 5678, Malone, NY 12953 | 2018-07-24 |
| 1164929212 | Cheryl Ann Grant | Registered Nurse | 15 Fourth Street, Malone, NY 12953 | 2018-04-06 |
| 1811408826 | Nancy Denis | Registered Nurse | 133 Park Street, Alice Hyde Medical Center, Malone, NY 12953 | 2017-10-17 |
| 1003325424 | Tara Lynn Ellis | Registered Nurse | 23 Husky Lane, Malone, NY 12953 | 2017-09-28 |
| 1578092185 | Shanna Lee Cayea | Peer Specialist | 31 6th Street, Malone, NY 12953 | 2017-06-07 |
| 1184007809 | Alice Hyde Medical Center | Home Health | 45 Sixth St, Malone, NY 12953 | 2015-06-30 |
| 1427303353 | Melissa J Benardot | Nurse Practitioner | 380 Cty Rt 57, Community Health Center, Malone, NY 12953 | 2012-07-17 |
| 1013272202 | Shafiu Oladele Ololade | Internal Medicine | 10 Third Street, Malone, NY 12953 | 2012-07-12 |
| Find all providers in zip 12953 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780203760 | Heather Lynn Lauzon | Peer Specialist | 15 Fouth St, Malone, NY 12953 | 2020-04-10 |
| 1578092185 | Shanna Lee Cayea | Peer Specialist | 31 6th Street, Malone, NY 12953 | 2017-06-07 |
| 1578177820 | Jenna Law | Peer Specialist | 15 4th St, Malone, NY 12953-1340 | 2020-09-03 |
| 1104459379 | Philip Todd Horsley | Peer Specialist | 31 6th St, Malone, NY 12953-1246 | 2020-02-17 |
| 1235776634 | Peter Randolph Terrance | Peer Specialist | 31 6th St, Malone, NY 12953-1246 | 2019-12-04 |
| 1033760087 | Nicholas Michael Harvey | Peer Specialist | 15 4th St, Malone, NY 12953-1340 | 2019-09-20 |
| 1255988382 | Lee Ann King | Peer Specialist | 15 4th St, Malone, NY 12953-1340 | 2019-08-22 |
| 1780231050 | Mark Collier | Peer Specialist | 15 4th St, Malone, NY 12953-1340 | 2019-08-21 |
| 1700344389 | Laura Jeanne Nicholas | Peer Specialist | 31 6th St, Malone, NY 12953-1246 | 2019-03-03 |
| 1568929123 | Shayna Marie Travers | Peer Specialist | 31 6th St, Malone, NY 12953-1246 | 2019-03-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.