Provider Demographics
NPI:1992980650
Name:MACNAMARA, MARK ALAN (LPC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:MACNAMARA
Suffix:
Gender:M
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:PO BOX 1943
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-1943
Mailing Address - Country:US
Mailing Address - Phone:903-892-2866
Mailing Address - Fax:903-893-5183
Practice Address - Street 1:1223 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7435
Practice Address - Country:US
Practice Address - Phone:903-892-2866
Practice Address - Fax:903-893-5183
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15278101YP2500X
OK2155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional