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Mackenzie Clegg
NPI 1013468065 · on the registry since 2016
Practice
- Address
- 790 Fuller Ave Ne
Grand Rapids, MI 49503 - Phone
- (616) 336-3909
- Fax
- (616) 336-8830
- Organisation at this address
- Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh AuthorityInferred from a shared address, not stated in the registry. - Clinicians at this address
- 395
Additional practice sites
- 120 Stevens St Sw, Grand Rapids, MI
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 247200000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-04-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan