Provider Demographics
NPI:1033095245
Name:PUTZIER, MAKENZIE (LCSW)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:
Last Name:PUTZIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SANGRIA DR
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-8453
Mailing Address - Country:US
Mailing Address - Phone:507-380-2361
Mailing Address - Fax:
Practice Address - Street 1:204 SANGRIA DR
Practice Address - Street 2:
Practice Address - City:VINE GROVE
Practice Address - State:KY
Practice Address - Zip Code:40175-8453
Practice Address - Country:US
Practice Address - Phone:507-380-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040155271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical