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901 E Main St Rockport TX 78382-2632 | |
| (361) 729-0633 | |
| (361) 790-8527 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 901 E Main St, Rockport, Texas |
| Authorized Official Name and Position | Candace Derrick (BOARD PRESIDENT) |
| Authorized Official Contact | 3617290633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
901 E Main St Rockport TX 78382-2632 Ph: (361) 729-0633 | 901 E Main St Rockport TX 78382-2632 Ph: (361) 729-0633 |
| NPI Number | 1235220054 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/02/2024 |
| Medicare PECOS PAC ID | 7315486511 |
|---|---|
| Medicare Enrollment ID | O20240903000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235220054 | NPI | - | NPPES |
| 081263801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Linda Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922118645 PECOS PAC ID: 2163961368 Enrollment ID: I20240903000617 |
| Provider Name | Anne Mourtaja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437595972 PECOS PAC ID: 7214477322 Enrollment ID: I20240904001499 |
John J Hopper Md Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2726 Highway 35 N, Rockport, TX 78382 Phone: 361-729-5357 Fax: 361-727-2036 | |
Cindi L Maddalone Ma Lpc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2806 Highway 35 N, Rockport, TX 78382 Phone: 361-729-5357 Fax: 361-727-2036 | |
Paul M Hamilton Phd Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Magnolia St, Rockport, TX 78382 Phone: 361-727-0143 Fax: 361-727-2036 |