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Mackenzie M Bolden , MS

Counselor β€’ Vancouver, WA

Active NPI 1417596925 Individual Practitioner Female Practitioner
Practice location in NPPES

10000 Ne 7th Ave Ste 403
Vancouver, WA 986854548

Call 3609523070 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

10000 Ne 7th Ave Ste 403

Vancouver, WA 986854548

Telephone 3609523070
Organization at the Same NPPES Address or Phone
Star Meadow Counseling, Pllc Facility NPI 1780061937

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Portland, OR. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Vancouver and Washington

661 active clinicians are listed under Counselor with a practice address in Vancouver, WA (11,352 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Vancouver

0.3% of these 661 clinicians have the CMS telehealth indicator.

0.8% of these 661 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-01-07
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES WA 61515373

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Secondary Practice Locations

6509 Se Carlton St

Portland, OR 972066627

Phone: 5099478327

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location December 07, 2024

Registered at 10000 NE 7TH AVE STE 403, VANCOUVER, WA 986854548 (Tel: 3609523070)

πŸ‘€
Provider Name / Credentials Updated December 07, 2024

Recorded as MACKENZIE BOLDEN, M.S.

πŸ“
Updated Practice Location July 31, 2024

Registered at 6509 SE CARLTON ST, PORTLAND, OR 972066627 (Tel: 5099478327)

πŸ“
Updated Business Mailing Address July 31, 2024

Registered at 6509 SE CARLTON ST, PORTLAND, OR 972066627 (Tel: 5099478327)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2024

Counselor (license number reported to NPPES: WA 61515373)

βœ…
NPI Profile Active December 31, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 31, 2019

Registered at 210 W SPRAGUE AVE, SPOKANE, WA 992013627 (Tel: 5097478224)

πŸ“
Business Mailing Address (Initial Record) December 31, 2019

Registered at 210 W SPRAGUE AVE, SPOKANE, WA 992013627 (Tel: 5097478224)

πŸ‘€
Provider Name / Credentials (Initial Record) December 31, 2019

Recorded as MACKENZIE DAVIDSON, B.A.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 31, 2019

Counselor

🟒
Initial NPI Registration & Enumeration December 31, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1417596925
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 31, 2019
Last Update: January 07, 2025
Sole Proprietor: No

Mailing Address

6509 Se Carlton St

Portland, OR 972066627

Phone: 5099478327

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.