| Enteave Pllc | |
|
8500 N Mopac Expy Ste 604 Austin TX 78759-8347 | |
| (512) 350-6236 | |
| (512) 792-4862 |
| Full Name | Enteave Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 8500 N Mopac Expy Ste 604, Austin, Texas |
| Authorized Official Name and Position | Adam Paine (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 5127486127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enteave Pllc 9631 Covey Ridge Ln Austin TX 78758-5818 Ph: (512) 748-6127 | Enteave Pllc 8500 N Mopac Expy Ste 604 Austin TX 78759-8347 Ph: (512) 350-6236 |
| NPI Number | 1093363962 |
|---|---|
| Provider Enumeration Date | 09/03/2019 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 9739410309 |
|---|---|
| Medicare Enrollment ID | O20191011001956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093363962 | NPI | - | NPPES |
| Provider Name | Polly J Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871641217 PECOS PAC ID: 9931207065 Enrollment ID: I20070613000205 |
| Provider Name | Cynthia Cecilia Corral |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497057335 PECOS PAC ID: 5597046359 Enrollment ID: I20170110002012 |
| Provider Name | Adam D Paine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588113989 PECOS PAC ID: 6305120171 Enrollment ID: I20170223001328 |
| Provider Name | Lisa Beth Skalla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114479516 PECOS PAC ID: 4587933023 Enrollment ID: I20170627001243 |
| Provider Name | Radhika Khara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447925953 PECOS PAC ID: 0648677674 Enrollment ID: I20210917002026 |
| Provider Name | Tzvi Prochnik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053994244 PECOS PAC ID: 4284013566 Enrollment ID: I20220616000549 |
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