Provider Demographics
NPI:1629585625
Name:HAYDEN, MACKINZIE KAY (MA, LPC-S)
Entity Type:Individual
Prefix:
First Name:MACKINZIE
Middle Name:KAY
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11615 ANGUS RD STE 218
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4066
Mailing Address - Country:US
Mailing Address - Phone:512-492-6200
Mailing Address - Fax:512-492-6201
Practice Address - Street 1:11615 ANGUS RD STE 218
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4066
Practice Address - Country:US
Practice Address - Phone:512-492-6200
Practice Address - Fax:512-492-6201
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1457525834OtherCENTER FOR RELATIONAL CARE