Provider Demographics
NPI:1033899703
Name:BRASHER, MACKENZIE ANN (LMFT ASSOCIATE, LCDC)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ANN
Last Name:BRASHER
Suffix:
Gender:F
Credentials:LMFT ASSOCIATE, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 OLYMPIA DR UNIT 270274
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-0109
Mailing Address - Country:US
Mailing Address - Phone:469-269-2008
Mailing Address - Fax:
Practice Address - Street 1:2300 OLYMPIA DR UNIT 270274
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75027-0109
Practice Address - Country:US
Practice Address - Phone:917-687-6876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16689101YA0400X
TX205084106H00000X
TX94635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist