KRISTINA WOODWARD MACKIE (NPI# 1780870998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780870998 |
| Entity Type | Individual |
| Full Name | KRISTINA WOODWARD MACKIE |
| Credential | MSW, LCSW |
| Practice Address |
5330 San Bernardino St Montclair CA 91763-2952 |
| Mailing Address |
9500 Etiwanda Ave Rancho Cucamonga CA 91739-9662 |
| Practice Telephone | 9093993751 |
| Mailing Telephone | (909) 463-5234 |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2017-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW #27104 | CA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
ASW 22155 | CA | Behavioral Health & Social Service Providers |
| Street Address |
5330 SAN BERNARDINO ST |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-2952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508991746 | Meredith Elena Medin | Marriage & Family Therapist | 5330 San Bernardino St, Montclair, CA 91763-2952 | 2007-02-21 |
| 1912104076 | Rosa I Winter | Social Worker | 5330 San Bernardino St, Montclair, CA 91763-2952 | 2007-06-29 |
| 1417150095 | David Rodriguez | Social Worker | 5330 San Bernardino St, Montclair, CA 91763-2952 | 2007-06-08 |
| 1396877361 | Jennifer Hsu Larratt-smith | Social Worker | 5330 San Bernardino St, Montclair, CA 91763-2952 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191759 | Lynne Margaret Eisenbrand | Social Worker | 289 Park St, Montclair, NJ 07043-2210 | 2020-10-13 |
| 1679180160 | Megan Fox | Social Worker | 21 Trinity Pl Apt 401, Montclair, NJ 07042-2739 | 2020-09-28 |
| 1457975591 | Julie Bilse Psychotherapy, LLC | Social Worker | 51 Upper Montclair Plz Ste 17, Montclair, NJ 07043-1340 | 2020-06-04 |
| 1952937047 | Rafanny Mangarelli | Social Worker | 311 Claremont Ave Ste 2a, Montclair, NJ 07042-2240 | 2020-03-20 |
| 1013547009 | Roseann Tuchman Shaiman | Social Worker | 111 Yantacaw Brook Rd, Montclair, NJ 07043-2524 | 2020-01-19 |
| 1811558497 | Victoria Britt, Lcsw, LLC | Social Worker | 211a Glenridge Ave, Montclair, NJ 07042-3645 | 2019-06-25 |
| 1194283374 | Krystle M Davis | Social Worker | 105 Grove St Ste 16-2, Montclair, NJ 07042-4051 | 2019-03-07 |
| 1881178838 | We Care Psychology Group LLC | Social Worker | 4878 Yale St, Montclair, CA 91763-2242 | 2018-09-17 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1902396104 | Trauma-informed Psychotherapy, LLC | Social Worker | 101 Park St # 3, Montclair, NJ 07042-2963 | 2018-05-14 |
| Find all providers in MONTCLAIR | ||||
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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.