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Individual

KEVIN MACK

Active
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Individual

KEVIN MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
82836
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
82836
TX
101YM0800X
Mental Health Counselor
82836
TX
101YP1600X
Pastoral Counselor
82836
TX
101YP2500X
Professional Counselor
Primary
82836
TX
101YS0200X
School Counselor
82836
TX
106H00000X
Marriage & Family Therapist
82836
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27286854
DRIVERS LICENSE
TX
Enumeration date
10/07/2019
Last updated
06/18/2024
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