| Agape Counseling, Llc | |
|
308 Almond Tree Ln Clovis NM 88101-1742 | |
| (850) 497-2265 | |
| Not Available |
| Full Name | Agape Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 308 Almond Tree Ln, Clovis, New Mexico |
| Authorized Official Name and Position | Seth Sebastian Baker (LCSW) |
| Authorized Official Contact | 8504972265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Counseling, Llc 308 Almond Tree Ln Clovis NM 88101-1742 Ph: (850) 497-2265 | Agape Counseling, Llc 308 Almond Tree Ln Clovis NM 88101-1742 Ph: (850) 497-2265 |
| NPI Number | 1245955111 |
|---|---|
| Provider Enumeration Date | 10/04/2022 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 7810337151 |
|---|---|
| Medicare Enrollment ID | O20240502003394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245955111 | NPI | - | NPPES |
| 1568012870 | Other | NM | TYPE 1 NPI |
| 21006768 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Seth Sebastian Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568012870 PECOS PAC ID: 8729428065 Enrollment ID: I20240502003609 |
| Provider Name | Lynn P Fronk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043348964 PECOS PAC ID: 9638519978 Enrollment ID: I20240509003008 |
| Provider Name | David Lee Rossen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700543147 PECOS PAC ID: 2567803232 Enrollment ID: I20240513000866 |
| Provider Name | Taylor Joanne Faver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043872815 PECOS PAC ID: 9133560865 Enrollment ID: I20240513003078 |
| Provider Name | Hannah Brooks Graves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194321968 PECOS PAC ID: 0648611947 Enrollment ID: I20240517001835 |
| Provider Name | Tawna Shay Speer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356675052 PECOS PAC ID: 6103268214 Enrollment ID: I20240521002334 |
| Provider Name | Angela N Lutz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154928604 PECOS PAC ID: 2264974294 Enrollment ID: I20240606000340 |
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