Provider Demographics
NPI:1174613046
Name:MCNEELY, ABIGAIL RANKIN (PSYD)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:RANKIN
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12741 RESEARCH BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4388
Mailing Address - Country:US
Mailing Address - Phone:512-302-1590
Mailing Address - Fax:512-836-5926
Practice Address - Street 1:12741 RESEARCH BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4388
Practice Address - Country:US
Practice Address - Phone:512-302-1590
Practice Address - Fax:512-836-5926
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219411041C0700X
TX36188103TB0200X, 103T00000X, 103TC1900X, 103TH0004X, 103TH0100X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89CTOtherBCBS PROVIDER #