Provider Demographics
NPI:1083337570
Name:MACKENZIE, ERIN (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MACKENZIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05462-0174
Mailing Address - Country:US
Mailing Address - Phone:978-868-5105
Mailing Address - Fax:
Practice Address - Street 1:206 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-4460
Practice Address - Country:US
Practice Address - Phone:978-868-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.01357331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical