Provider Demographics
NPI:1972364867
Name:LOWE, MACKENZIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MACKENZIE
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 BRAZOS ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3902
Mailing Address - Country:US
Mailing Address - Phone:903-714-6258
Mailing Address - Fax:
Practice Address - Street 1:446 ELM ST STE 1
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-2500
Practice Address - Country:US
Practice Address - Phone:940-532-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional