| Engedi Life Care, Pllc | |
|
201 S Lakeline Blvd Ste 103 Cedar Park TX 78613-2719 | |
| (512) 528-5356 | |
| Not Available |
| Full Name | Engedi Life Care, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 201 S Lakeline Blvd Ste 103, Cedar Park, Texas |
| Authorized Official Name and Position | Pamela A Bermender (THERAPIST & SOLE OWNER) |
| Authorized Official Contact | 5122010741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Engedi Life Care, Pllc 3550 N Lakeline Blvd Ste 170-1515 Leander TX 78641-3504 Ph: (512) 201-0741 | Engedi Life Care, Pllc 201 S Lakeline Blvd Ste 103 Cedar Park TX 78613-2719 Ph: (512) 528-5356 |
| NPI Number | 1508140971 |
|---|---|
| Provider Enumeration Date | 10/04/2011 |
| Last Update Date | 09/26/2024 |
| Certification Date | 09/26/2024 |
| Medicare PECOS PAC ID | 3375986037 |
|---|---|
| Medicare Enrollment ID | O20240209000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508140971 | NPI | - | NPPES |
| 201504 | Other | TX | MFT LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 201504 (Texas) | Primary |
| Provider Name | Pamela A Bermender |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104179233 PECOS PAC ID: 8628411386 Enrollment ID: I20240209000388 |
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