Provider Demographics
NPI:1457030538
Name:MCCRACKEN, DEBORAH M (BCBC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:BCBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-4355
Mailing Address - Country:US
Mailing Address - Phone:817-525-3370
Mailing Address - Fax:
Practice Address - Street 1:18010 FM 1488 RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-8562
Practice Address - Country:US
Practice Address - Phone:832-302-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor