Provider Demographics
NPI:1194477851
Name:BARNES, MACKENZIE R (LMSW)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:R
Last Name:BARNES
Suffix:
Gender:F
Credentials:LMSW
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 781333
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67278-1333
Mailing Address - Country:US
Mailing Address - Phone:316-871-0292
Mailing Address - Fax:
Practice Address - Street 1:8100 E 22ND ST N STE 800
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2388
Practice Address - Country:US
Practice Address - Phone:316-871-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12409104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker