| |
2310 S Willis St Abilene TX 79605-6226 | |
(325) 704-2400 | |
Not Available |
Full Name | |
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Speciality | Counselor |
Location | 2310 S Willis St, Abilene, Texas |
Authorized Official Name and Position | Joshua Hardwick (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3257042314 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2310 S Willis St Abilene TX 79605-6226 Ph: (325) 704-2400 | 2310 S Willis St Abilene TX 79605-6226 Ph: (325) 704-2400 |
NPI Number | 1205699899 |
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Provider Enumeration Date | 02/05/2024 |
Last Update Date | 01/10/2025 |
Certification Date | 01/10/2025 |
Medicare PECOS PAC ID | 1052859345 |
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Medicare Enrollment ID | O20240819000351 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205699899 | NPI | - | NPPES |
Provider Name | Cali Hellums |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790428290 PECOS PAC ID: 0446608202 Enrollment ID: I20231205000726 |
Provider Name | Jennifer D Rasco |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1497512313 PECOS PAC ID: 0345783015 Enrollment ID: I20240621003788 |
Provider Name | Christopher Jordan Subia |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1215779459 PECOS PAC ID: 8628516929 Enrollment ID: I20240819000696 |
Provider Name | Valerie Roper |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1952183915 PECOS PAC ID: 9436699006 Enrollment ID: I20240910001799 |
Provider Name | Rebecca Haught |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1053807867 PECOS PAC ID: 2062953243 Enrollment ID: I20240916003358 |
Provider Name | Ashlen Walker |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1689356545 PECOS PAC ID: 2567903743 Enrollment ID: I20240916003641 |
Provider Name | Matthew Thompson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1538756663 PECOS PAC ID: 2365983335 Enrollment ID: I20240917004572 |
Provider Name | Caroline Park |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1518705573 PECOS PAC ID: 7214478262 Enrollment ID: I20240918002329 |
Provider Name | Robert Samsel |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1174881783 PECOS PAC ID: 0345776514 Enrollment ID: I20241211001765 |
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