| Cedar Creek Wellness Group | |
|
1837 W Main St Gun Barrel City TX 75156-4401 | |
| (903) 910-2294 | |
| (949) 577-4350 |
| Full Name | Cedar Creek Wellness Group |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1837 W Main St, Gun Barrel City, Texas |
| Authorized Official Name and Position | Lauren Kay Hughes (CO-OWNER) |
| Authorized Official Contact | 8176751335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Creek Wellness Group 188 Rueda Encina St Gun Barrel City TX 75156-4302 Ph: (817) 675-1335 | Cedar Creek Wellness Group 1837 W Main St Gun Barrel City TX 75156-4401 Ph: (903) 910-2294 |
| NPI Number | 1922648310 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 08/30/2020 |
| Certification Date | 08/30/2020 |
| Medicare PECOS PAC ID | 5890125231 |
|---|---|
| Medicare Enrollment ID | O20200424002949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922648310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Judith D Sutherland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851611503 PECOS PAC ID: 6608046966 Enrollment ID: I20110824000878 |
| Provider Name | Hector Medellin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497355929 PECOS PAC ID: 3870908403 Enrollment ID: I20210212001179 |
| Provider Name | Jeanie Diane Dunlap |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760806426 PECOS PAC ID: 2466856729 Enrollment ID: I20210809001372 |
| Provider Name | Cheryl Lynn Lauderdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811647571 PECOS PAC ID: 2163884776 Enrollment ID: I20230815000213 |
East Texas Neurobehavioral Health,pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 122 S Gun Barrel Ln, Suite 6, Gun Barrel City, TX 75156 Phone: 903-887-0697 Fax: 903-887-0698 |