MEDICARE: MACKENZIE ANN THAYER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	80837	TX

General Provider Information

NPI Number	:	1336713940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE ANN THAYER LPC

Provider Business Mailing Address
First Line	:	3505 OLSEN BLVD STE 210
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3032
Country	:	US
Telephone Number	:	806-410-0708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 OLSEN BLVD STE 210
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3032
Country	:	US
Telephone Number	:	806-341-9966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	10/09/2025

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Directions to “ MACKENZIE ANN THAYER LPC” Practice Location

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