Mackenzie Gangl, LICSW is a
Counselor - Mental Health based in Brainerd, Minnesota. Mackenzie Gangl is licensed to practice in Minnesota (license number 16191) and her current practice location is
823 Maple St, Brainerd, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(320) 584-4121.
NPI number for Mackenzie Gangl is 1346517786 and her current mailing address is Po Box 9859, Fargo, North Dakota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1346517786.
Healthcare Provider's Profile
| Full Name | Mackenzie Gangl |
|---|
| Gender | Female |
|---|
| Speciality | Counselor - Mental Health |
|---|
| Location | 823 Maple St, Brainerd, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346517786
- Provider Enumeration Date: 11/30/2011
- Last Update Date: 10/20/2022
Medical Identifiers
Medical identifiers for Mackenzie Gangl such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346517786 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | 16191 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mackenzie Gangl is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mackenzie Gangl, LICSW
Po Box 9859,
Fargo, ND 58106-9859
Ph: (701) 451-4900 | Mackenzie Gangl, LICSW
823 Maple St,
Brainerd, MN 56401-3770
Ph: (320) 584-4121 |
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