Provider Demographics
NPI:1346126737
Name:CLARKE, MACKENZIE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 SEWANEE AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2242
Mailing Address - Country:US
Mailing Address - Phone:806-570-6485
Mailing Address - Fax:
Practice Address - Street 1:4151 SOUTHWEST FWY STE 760
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7306
Practice Address - Country:US
Practice Address - Phone:713-364-9317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health