Provider Demographics
NPI:1255371829
Name:MCNEEL, PRESTON MAVERICK (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:MAVERICK
Last Name:MCNEEL
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7254 BLANCO RD STE 204
Mailing Address - Street 2:7254 BLANCO RD STE 204
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4930
Mailing Address - Country:US
Mailing Address - Phone:210-884-8444
Mailing Address - Fax:830-386-0030
Practice Address - Street 1:7254 BLANCO RD STE 204
Practice Address - Street 2:7254 BLANCO RD STE 204
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4930
Practice Address - Country:US
Practice Address - Phone:210-884-8444
Practice Address - Fax:830-386-0030
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17720101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156696001Medicaid
TX6703LCOtherBCBS OF TEXAS