Chase C McKinney, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

76786 Issued in TX

Practice address

9396 Confederate Park Rd
Lakeside, TX 76135-4916

Phone

(817) 542-2111

NPI assigned

Sep 2, 2019

Last updated

Sep 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pathfinder Counseling and Consulting

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakeside, TX
  • NPI 1053969071
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567382400000",
    "number": "1205484342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 RIVER ROCK DR",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760201156",
            "telephone_number": "817-542-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9396 CONFEDERATE PARK RD",
            "city": "LAKESIDE",
            "state": "TX",
            "postal_code": "761354916",
            "telephone_number": "817-542-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "CHASE",
        "middle_name": "C",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-02",
        "last_updated": "2019-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "76786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariella E Clark, LCSW
• Kathi Edmonson
• Kimberli Paige Edmonson, SLP-ASSISTANT
• Noble U. Ezukanma, M.D.
• Mainstream Habilitation Services of Texas, Inc.
• Pathfinder Counseling and Consulting
• Sage Substance Abuse Guidance and Education
• Kelle Creecy White, LCSW-S

• Mental Health Counselor in Lakeside, TX
• Providers in Lakeside, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.