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303 S Highway 78 Suite 100 Wylie TX 75098-3944 | |
| (469) 342-3468 | |
| (469) 342-3466 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 303 S Highway 78, Wylie, Texas |
| Authorized Official Name and Position | Vanessa Gill (OWNER) |
| Authorized Official Contact | 4693423468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
303 S Highway 78 Suite 100 Wylie TX 75098-3944 Ph: (469) 342-3468 | 303 S Highway 78 Suite 100 Wylie TX 75098-3944 Ph: (469) 342-3468 |
| NPI Number | 1912447681 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 11/02/2021 |
| Certification Date | 11/02/2021 |
| Medicare PECOS PAC ID | 3173809621 |
|---|---|
| Medicare Enrollment ID | O20170417001665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912447681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 50358 (Texas) | Primary |
| Provider Name | Vanessa M Gill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477812311 PECOS PAC ID: 3476871559 Enrollment ID: I20150422000399 |
| Provider Name | Amanda R Cortez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205274149 PECOS PAC ID: 2264752336 Enrollment ID: I20150514000198 |
| Provider Name | Ditallianna E Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326531054 PECOS PAC ID: 9830420660 Enrollment ID: I20191009002378 |
| Provider Name | Jill Yarbrough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932734639 PECOS PAC ID: 6305267717 Enrollment ID: I20200610001325 |
| Provider Name | Kara M Talton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790923738 PECOS PAC ID: 1557770641 Enrollment ID: I20210430001199 |
| Provider Name | Alana C Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619514080 PECOS PAC ID: 3577967496 Enrollment ID: I20210813001627 |
| Provider Name | Samantha Nicole Barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710652623 PECOS PAC ID: 4981002037 Enrollment ID: I20211005000741 |
| Provider Name | Buffy D Owens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639845944 PECOS PAC ID: 1759771165 Enrollment ID: I20211129001459 |
| Provider Name | Kami Hawk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518532159 PECOS PAC ID: 4284028929 Enrollment ID: I20220223001968 |
| Provider Name | Ngwe Kien Kimbeng Belinda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750083523 PECOS PAC ID: 6406215714 Enrollment ID: I20230705002120 |
| Provider Name | Brooklynn Alexis Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629856166 PECOS PAC ID: 8123476868 Enrollment ID: I20231119000119 |
| Provider Name | Sheila M Ruble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861602708 PECOS PAC ID: 2264875525 Enrollment ID: I20240205000448 |
| Provider Name | Axel R Cristales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306438551 PECOS PAC ID: 8527401652 Enrollment ID: I20240206002460 |
| Provider Name | Cynthia M Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104588102 PECOS PAC ID: 4486097490 Enrollment ID: I20240207000382 |
| Provider Name | Stephanie H Collier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720751357 PECOS PAC ID: 5496198327 Enrollment ID: I20240208000346 |
| Provider Name | Elizabeth R Bobo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396216487 PECOS PAC ID: 5698119766 Enrollment ID: I20240216000417 |
| Provider Name | Rayven C Peck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316426315 PECOS PAC ID: 6507200623 Enrollment ID: I20240216002413 |
| Provider Name | Jon Charles Mccoy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013447325 PECOS PAC ID: 6305280827 Enrollment ID: I20240222003423 |
| Provider Name | Jennifer Seng |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801460324 PECOS PAC ID: 8628412194 Enrollment ID: I20240223000873 |
| Provider Name | Natalie N Fetsch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538836804 PECOS PAC ID: 4385089754 Enrollment ID: I20240226003158 |
| Provider Name | Kara L Schramm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912456112 PECOS PAC ID: 5294171211 Enrollment ID: I20240313001978 |
| Provider Name | Jennifer S Kelling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760099675 PECOS PAC ID: 5193161990 Enrollment ID: I20240315000686 |
| Provider Name | Toni S Webb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770253973 PECOS PAC ID: 9739622119 Enrollment ID: I20240614000610 |
| Provider Name | Courtney L Ruetz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275271009 PECOS PAC ID: 2264975549 Enrollment ID: I20240614000764 |
| Provider Name | Amanda L Estep |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073218905 PECOS PAC ID: 2668910167 Enrollment ID: I20240815000720 |
| Provider Name | Binoy Thannikkodan Kuriakose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376907444 PECOS PAC ID: 1850823659 Enrollment ID: I20241017003614 |
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