Provider Demographics
NPI:1558753509
Name:STORMS, MCKENZIE (MA, LPC)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:STORMS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20761 MAJESTIC CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8322
Mailing Address - Country:US
Mailing Address - Phone:541-203-3968
Mailing Address - Fax:
Practice Address - Street 1:373 NE GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4605
Practice Address - Country:US
Practice Address - Phone:541-343-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-27
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional