| From Darkness To Light Prophetic Counseling Llc | |
|
1380 Pantheon Way San Antonio TX 78232-2288 | |
| (726) 842-0498 | |
| Not Available |
| Full Name | From Darkness To Light Prophetic Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1380 Pantheon Way, San Antonio, Texas |
| Authorized Official Name and Position | Mary R Moseley (OWNER) |
| Authorized Official Contact | 7268420498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| From Darkness To Light Prophetic Counseling Llc 21750 Hardy Oak Blvd. Ste. 104 #660606 San Antonio TX 78258 Ph: (726) 842-0498 | From Darkness To Light Prophetic Counseling Llc 1380 Pantheon Way San Antonio TX 78232-2288 Ph: (726) 842-0498 |
| NPI Number | 1740040203 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Medicare PECOS PAC ID | 9739520503 |
|---|---|
| Medicare Enrollment ID | O20240510000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740040203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary R Moseley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417302415 PECOS PAC ID: 0648611418 Enrollment ID: I20240510000924 |
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