MEDICARE: MACEY MCCLENEN MS, 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	86232	TX

General Provider Information

NPI Number	:	1639936701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACEY MCCLENEN MS, LPC

Provider Business Mailing Address
First Line	:	4800 MANOR RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-5522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 MANOR RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-5522
Country	:	US
Telephone Number	:	512-927-4746
Fax Number	:

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

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	04/08/2025

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