| Deer Oaks Mid-west Llc | |
|
7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 | |
| (210) 615-3483 | |
| Not Available |
| Full Name | Deer Oaks Mid-west Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7272 Wurzbach Rd Ste 601, San Antonio, Texas |
| Authorized Official Name and Position | Paul A Boskind (CEO-OWNER) |
| Authorized Official Contact | 2106153483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Oaks Mid-west Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (210) 615-3483 | Deer Oaks Mid-west Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (210) 615-3483 |
| NPI Number | 1154978476 |
|---|---|
| Provider Enumeration Date | 08/21/2019 |
| Last Update Date | 08/29/2023 |
| Certification Date | 08/29/2023 |
| Medicare PECOS PAC ID | 2264762681 |
|---|---|
| Medicare Enrollment ID | O20190927002974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154978476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Valerie Beavers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861455297 PECOS PAC ID: 7719965276 Enrollment ID: I20040710000401 |
| Provider Name | Jerome J Klinkner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124273149 PECOS PAC ID: 8527090497 Enrollment ID: I20050906000738 |
| Provider Name | Daniel J Kozubal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215037502 PECOS PAC ID: 6507940053 Enrollment ID: I20080222000345 |
| Provider Name | Dawn H Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699817593 PECOS PAC ID: 3274612676 Enrollment ID: I20080510000107 |
| Provider Name | Kellie E Branch-dircks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255528204 PECOS PAC ID: 5991874257 Enrollment ID: I20080513000606 |
| Provider Name | Anne A Gephart Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780686857 PECOS PAC ID: 5698847168 Enrollment ID: I20080630000071 |
| Provider Name | Monte Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427208438 PECOS PAC ID: 2769546647 Enrollment ID: I20090122000257 |
| Provider Name | Leigh M Johnson-migalski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891833711 PECOS PAC ID: 1850442914 Enrollment ID: I20090701000013 |
| Provider Name | Ellen M Stone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104050335 PECOS PAC ID: 3072643485 Enrollment ID: I20100611000122 |
| Provider Name | Karyn B Cihak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770569402 PECOS PAC ID: 3274665377 Enrollment ID: I20100723000872 |
| Provider Name | Kelly Ann Pettit |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194999409 PECOS PAC ID: 5890988984 Enrollment ID: I20101021000562 |
| Provider Name | Christina Irmgard Alexakos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265731533 PECOS PAC ID: 2062699648 Enrollment ID: I20110608000162 |
| Provider Name | Carrie A Jura |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326357351 PECOS PAC ID: 4082874086 Enrollment ID: I20120329000166 |
| Provider Name | Cindi Marie D Willoughby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487929345 PECOS PAC ID: 8820259716 Enrollment ID: I20120420000244 |
| Provider Name | Patricia E Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568729473 PECOS PAC ID: 0749442101 Enrollment ID: I20120501000203 |
| Provider Name | Mary Alice Diamond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710256375 PECOS PAC ID: 4981866167 Enrollment ID: I20120504000227 |
| Provider Name | Anna Sarenac |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134491137 PECOS PAC ID: 2466616651 Enrollment ID: I20120620000329 |
| Provider Name | Patty L Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629384573 PECOS PAC ID: 5092965921 Enrollment ID: I20121030000231 |
| Provider Name | Regina R Freeman-hodges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568750065 PECOS PAC ID: 4385883693 Enrollment ID: I20130618000341 |
| Provider Name | Caryn E Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154763589 PECOS PAC ID: 1951544642 Enrollment ID: I20130828000416 |
| Provider Name | Starr L Baize |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457607848 PECOS PAC ID: 6901021427 Enrollment ID: I20140625001503 |
| Provider Name | Shani D Bensman-correa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306258033 PECOS PAC ID: 7810210168 Enrollment ID: I20141218000468 |
| Provider Name | Victoria Duran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740672252 PECOS PAC ID: 7618295866 Enrollment ID: I20150420000236 |
| Provider Name | Russell S Mccormack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881000826 PECOS PAC ID: 3173842317 Enrollment ID: I20150509000103 |
| Provider Name | Stephanie R Armanetti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669863437 PECOS PAC ID: 4082935671 Enrollment ID: I20150608002499 |
| Provider Name | David N Gershan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770830275 PECOS PAC ID: 0547570681 Enrollment ID: I20151102002470 |
| Provider Name | James E Vanderbosch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972526796 PECOS PAC ID: 3971805375 Enrollment ID: I20151231000310 |
| Provider Name | Christina Nyree Harmon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568890242 PECOS PAC ID: 6204128259 Enrollment ID: I20160712001210 |
| Provider Name | Dena R Verderame |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255635835 PECOS PAC ID: 9032495866 Enrollment ID: I20170411000461 |
| Provider Name | Hope A Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588051767 PECOS PAC ID: 5991072183 Enrollment ID: I20170518000222 |
| Provider Name | Hillarie A Mieure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255757043 PECOS PAC ID: 5698041606 Enrollment ID: I20171018003648 |
| Provider Name | Helen R Schaeffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487183794 PECOS PAC ID: 9436418191 Enrollment ID: I20180125002861 |
| Provider Name | Lisa A Valiente |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740781889 PECOS PAC ID: 2567724818 Enrollment ID: I20180326001520 |
| Provider Name | Beverly A Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891203956 PECOS PAC ID: 7810250644 Enrollment ID: I20180410000089 |
| Provider Name | Sanka Samardzija |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639483878 PECOS PAC ID: 6305074543 Enrollment ID: I20181002000649 |
| Provider Name | Tomy K Kannala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417430216 PECOS PAC ID: 1850643065 Enrollment ID: I20181016001186 |
| Provider Name | Jason P Morris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447529789 PECOS PAC ID: 0244596211 Enrollment ID: I20181115001941 |
| Provider Name | Alexander Chacko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417901620 PECOS PAC ID: 3476898586 Enrollment ID: I20181218002390 |
| Provider Name | Tammie Denise Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043790017 PECOS PAC ID: 2567707318 Enrollment ID: I20181222000380 |
| Provider Name | Marci E Balonick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285193995 PECOS PAC ID: 1153662481 Enrollment ID: I20190412002176 |
| Provider Name | Kathryn Lee Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962950717 PECOS PAC ID: 5395161012 Enrollment ID: I20200812001630 |
| Provider Name | Kathee Joliene Foxan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366756454 PECOS PAC ID: 0648497487 Enrollment ID: I20200930001290 |
| Provider Name | Keisha L Battle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750899050 PECOS PAC ID: 2567873573 Enrollment ID: I20201124000551 |
| Provider Name | Tracy Michelle Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023655750 PECOS PAC ID: 5890109573 Enrollment ID: I20210121001332 |
| Provider Name | Mary Josie Klass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386236271 PECOS PAC ID: 8123433232 Enrollment ID: I20210224000380 |
| Provider Name | Britni E Hulser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598273120 PECOS PAC ID: 7315207487 Enrollment ID: I20210405001668 |
| Provider Name | Dana R Boyland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174787535 PECOS PAC ID: 9537444567 Enrollment ID: I20210527000691 |
| Provider Name | William Joseph Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902985534 PECOS PAC ID: 4587728464 Enrollment ID: I20210824003015 |
| Provider Name | Alexandra Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609490481 PECOS PAC ID: 1759779911 Enrollment ID: I20211021001050 |
| Provider Name | Ted Brian Cravens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235725144 PECOS PAC ID: 7618365438 Enrollment ID: I20211028000906 |
| Provider Name | Athanasia Nancy Metz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497412241 PECOS PAC ID: 8224428842 Enrollment ID: I20211214000350 |
| Provider Name | Joanne Marie Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629723309 PECOS PAC ID: 0648664680 Enrollment ID: I20220308001519 |
| Provider Name | Nina Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639359698 PECOS PAC ID: 6507083896 Enrollment ID: I20220512000929 |
| Provider Name | Daniel A Bass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205550167 PECOS PAC ID: 7810363793 Enrollment ID: I20221018000874 |
| Provider Name | Carolyn A Kanagy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801121017 PECOS PAC ID: 8022145903 Enrollment ID: I20221208002400 |
| Provider Name | Lorraine M Hecht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033822739 PECOS PAC ID: 0547255234 Enrollment ID: I20230113000104 |
| Provider Name | Edward Jason Muldrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851378814 PECOS PAC ID: 0244201879 Enrollment ID: I20230118001442 |
| Provider Name | Laila Maria Ashkazari |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043687676 PECOS PAC ID: 0547613671 Enrollment ID: I20240125000901 |
| Provider Name | Tyler Leonardo Pena |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518457365 PECOS PAC ID: 2769825868 Enrollment ID: I20240206001520 |
| Provider Name | Patrick Thomas Noonan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205352192 PECOS PAC ID: 6204279367 Enrollment ID: I20240206003553 |
| Provider Name | Christopher G Perkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104094630 PECOS PAC ID: 6800233859 Enrollment ID: I20240326001929 |
| Provider Name | Jean M Hannigan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922123876 PECOS PAC ID: 5496298895 Enrollment ID: I20240613001989 |
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