Individual
CATHERINE S.C. MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCSW
Contact information
Practice address
444 SOUTH ADAMS ST, SUITE 6, GREEN BAY, WI 54301
(715) 526-5466
(715) 526-5545
Mailing address
1415 EAST GREEN BAY ST., SUITE 191, SHAWANO, WI 54166-3881
(715) 526-5466
(715) 526-5545
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2261123
WI
101YM0800X
Mental Health Counselor
Primary
—
WI
1041C0700X
Clinical Social Worker
2261-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11661651
CAQH
—
05
—
39737500
—
WI
Enumeration date
10/02/2006
Last updated
06/30/2009
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