Amanda Beth Groller, LPC | |
4444 W Main St, League City, TX 77573-1737 | |
(409) 763-2373 | |
Not Available |
Full Name | Amanda Beth Groller |
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Gender | Female |
Speciality | Counselor |
Location | 4444 W Main St, League City, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043414071 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 61748 (Texas) | Primary |
Entity Name | The Gulf Coast Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245285899 PECOS PAC ID: 6204821895 Enrollment ID: O20040414001641 |
Mailing Address | Practice Location Address |
---|---|
Amanda Beth Groller, LPC 4444 W Main St, League City, TX 77573-1737 Ph: (409) 763-2373 | Amanda Beth Groller, LPC 4444 W Main St, League City, TX 77573-1737 Ph: (409) 763-2373 |
Denise Rau, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2600 S Shore Blvd Ste 373, League City, TX 77573 Phone: 281-245-3389 | |
Scot R Macomber, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 W Main St Ste 101, League City, TX 77573 Phone: 281-299-5959 | |
Charlette Hart Vaughn, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 221 N Michigan Ave, League City, TX 77573 Phone: 832-895-9945 | |
Vickie Rabino, Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 Enterprise Ave Ste 650, League City, TX 77573 Phone: 281-937-4133 | |
Mrs. Tashonda Edwards, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1828 Wren Dr, League City, TX 77573 Phone: 409-739-2701 | |
Courtney Renee Trinidad, LCDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4444 W Main St, League City, TX 77573 Phone: 409-763-2373 Fax: 409-978-2401 |