| Caladium Counseling, Pllc | |
|
10300 N Central Expy Ste 220 Dallas TX 75231-8626 | |
| (651) 313-8080 | |
| Not Available |
| Full Name | Caladium Counseling, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 10300 N Central Expy Ste 220, Dallas, Texas |
| Authorized Official Name and Position | Bryan Macktinger (OWNER) |
| Authorized Official Contact | 2147247090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caladium Counseling, Pllc 5909 Azalea Ln Dallas TX 75230-3403 Ph: () - | Caladium Counseling, Pllc 10300 N Central Expy Ste 220 Dallas TX 75231-8626 Ph: (651) 313-8080 |
| NPI Number | 1942947080 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 05/19/2022 |
| Certification Date | 05/19/2022 |
| Medicare PECOS PAC ID | 4385001957 |
|---|---|
| Medicare Enrollment ID | O20230613002483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942947080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Andrea Slaughter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871934000 PECOS PAC ID: 5597150383 Enrollment ID: I20220314001226 |
| Provider Name | Faithe Mistretta-hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437825338 PECOS PAC ID: 8426425083 Enrollment ID: I20221110002284 |
| Provider Name | Kimberly Gaylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508179946 PECOS PAC ID: 8628203668 Enrollment ID: I20230614003597 |
| Provider Name | Alejandra Laidale Lazalde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811466774 PECOS PAC ID: 1052763950 Enrollment ID: I20240116003788 |
| Provider Name | Cinda Renee Breazeale |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346824596 PECOS PAC ID: 1355793183 Enrollment ID: I20240117003723 |
| Provider Name | Kira H Hartgrove |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295899904 PECOS PAC ID: 2567809106 Enrollment ID: I20240319002058 |
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