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6300 West Loop S Ste 110 Bellaire TX 77401-2919 | |
| (832) 924-0348 | |
| (832) 852-5754 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 6300 West Loop S Ste 110, Bellaire, Texas |
| Authorized Official Name and Position | Jeniffer K Esclovon (OWNER) |
| Authorized Official Contact | 4096261329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6300 West Loop S Ste 110 Bellaire TX 77401-2919 Ph: (832) 924-0348 | 6300 West Loop S Ste 110 Bellaire TX 77401-2919 Ph: (832) 924-0348 |
| NPI Number | 1487372132 |
|---|---|
| Provider Enumeration Date | 08/18/2022 |
| Last Update Date | 09/13/2024 |
| Certification Date | 09/09/2024 |
| Medicare PECOS PAC ID | 4981065596 |
|---|---|
| Medicare Enrollment ID | O20230731000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487372132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lynsay Erin Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619491701 PECOS PAC ID: 1052659034 Enrollment ID: I20190218001281 |
| Provider Name | Sable Mcelveen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912659491 PECOS PAC ID: 9335534841 Enrollment ID: I20220321001011 |
| Provider Name | David R Castele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922657113 PECOS PAC ID: 5799146155 Enrollment ID: I20230801003045 |
| Provider Name | Regina Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922715135 PECOS PAC ID: 7517319114 Enrollment ID: I20240119000410 |
| Provider Name | Efrain Gonzalez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558380113 PECOS PAC ID: 9436501046 Enrollment ID: I20240119000794 |
| Provider Name | Jeniffer Kay Esclovon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649510694 PECOS PAC ID: 8426419037 Enrollment ID: I20240119001249 |
| Provider Name | Shacolby J Dedmond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992460356 PECOS PAC ID: 8325482730 Enrollment ID: I20240213004363 |
| Provider Name | Daisey M Mccloud |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568855997 PECOS PAC ID: 1850736232 Enrollment ID: I20240226000217 |
| Provider Name | Rendie Brown |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386093458 PECOS PAC ID: 4183085541 Enrollment ID: I20240301003058 |
| Provider Name | Shanica Jones-colson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235533712 PECOS PAC ID: 5092157792 Enrollment ID: I20240528000401 |
| Provider Name | Elizabeth Mary Efua Wilmot |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376314724 PECOS PAC ID: 4385185636 Enrollment ID: I20240926001219 |
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