Provider Demographics
NPI:1255861290
Name:RANKIN, MCKENNA (MRC, LPC)
Entity Type:Individual
Prefix:
First Name:MCKENNA
Middle Name:
Last Name:RANKIN
Suffix:
Gender:F
Credentials:MRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 HAINES AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4041
Mailing Address - Country:US
Mailing Address - Phone:817-809-2230
Mailing Address - Fax:
Practice Address - Street 1:1114 HAINES AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4041
Practice Address - Country:US
Practice Address - Phone:817-809-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional