Provider Demographics
NPI:1841345048
Name:MCNEEL, EVELYN MIXSON (LPC, LCDC, AAC)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:MIXSON
Last Name:MCNEEL
Suffix:
Gender:F
Credentials:LPC, LCDC, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W RIDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2325
Mailing Address - Country:US
Mailing Address - Phone:210-325-1567
Mailing Address - Fax:210-732-7618
Practice Address - Street 1:14815 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3708
Practice Address - Country:US
Practice Address - Phone:210-494-1991
Practice Address - Fax:210-494-7575
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8989101YA0400X
TX16830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1479883Medicaid