Provider Demographics
NPI:1063256394
Name:SWENSEN, MACKENZIE (LCSW)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:SWENSEN
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 1:114 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2224
Mailing Address - Country:US
Mailing Address - Phone:978-998-1662
Mailing Address - Fax:
Practice Address - Street 1:114 VALLEY ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2224
Practice Address - Country:US
Practice Address - Phone:978-998-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2283471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical