| Lakes Regional Community Center | |
|
400 Airport Rd Terrell TX 75160-4302 | |
| (972) 524-4159 | |
| (972) 563-5321 |
| Full Name | Lakes Regional Community Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 400 Airport Rd, Terrell, Texas |
| Authorized Official Name and Position | Erwin Hancock (CFO) |
| Authorized Official Contact | 9725244159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakes Regional Community Center 400 Airport Rd P O Box 747 Terrell TX 75160 Ph: (972) 524-4159 | Lakes Regional Community Center 400 Airport Rd Terrell TX 75160-4302 Ph: (972) 524-4159 |
| NPI Number | 1881752715 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 12/10/2018 |
| Medicare PECOS PAC ID | 9739175225 |
|---|---|
| Medicare Enrollment ID | O20040421000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881752715 | NPI | - | NPPES |
| 126813 | Other | TX | SUPERIOR GRP |
| CK7759 | Other | TX | PALMETTO GRP |
| LAKES-001 | Other | TX | COMPCARE GRP |
| 10001427 | Other | TX | AMERIGROUP GRP |
| 121988304 | Medicaid | TX | |
| 121988305 | Medicaid | TX | |
| 126278 | Other | TX | VO GRP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Alice A Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396720660 PECOS PAC ID: 6507778057 Enrollment ID: I20031103000532 |
| Provider Name | Rebecca F Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942238316 PECOS PAC ID: 0840263018 Enrollment ID: I20040816001212 |
| Provider Name | Carol L Starr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740283076 PECOS PAC ID: 4981677960 Enrollment ID: I20040817001335 |
| Provider Name | Jim O Lloyd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649310517 PECOS PAC ID: 9830166594 Enrollment ID: I20040914000403 |
| Provider Name | Philip R Taft |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285762120 PECOS PAC ID: 3375508203 Enrollment ID: I20041122000086 |
| Provider Name | Amy K Novak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043254097 PECOS PAC ID: 6406867456 Enrollment ID: I20060831000042 |
| Provider Name | Avrim Brett Fishkind |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093727943 PECOS PAC ID: 2466539804 Enrollment ID: I20080409000300 |
| Provider Name | Keith William Caramelli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538211941 PECOS PAC ID: 6204973886 Enrollment ID: I20091030000409 |
| Provider Name | Gary D Lefkof |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356570253 PECOS PAC ID: 9537207949 Enrollment ID: I20091104000721 |
| Provider Name | Shanna M Trelford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568525434 PECOS PAC ID: 0941338776 Enrollment ID: I20100514000336 |
| Provider Name | Abimbola Olufemi Layeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811962384 PECOS PAC ID: 2466584131 Enrollment ID: I20100715000331 |
| Provider Name | Herbert M Walling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154445492 PECOS PAC ID: 0941499198 Enrollment ID: I20110104000973 |
| Provider Name | Kristen H Grable |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720001118 PECOS PAC ID: 1254510514 Enrollment ID: I20110119001018 |
| Provider Name | Eric S Kemp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174681589 PECOS PAC ID: 6002090537 Enrollment ID: I20110407000697 |
| Provider Name | Theresa J Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235433533 PECOS PAC ID: 2668646886 Enrollment ID: I20111123000647 |
| Provider Name | Kathy J Hickman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689738643 PECOS PAC ID: 9830346576 Enrollment ID: I20120830000781 |
| Provider Name | Johnes B Monyoncho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427301597 PECOS PAC ID: 4587815048 Enrollment ID: I20121108000620 |
| Provider Name | Lyle B Montgomery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730208158 PECOS PAC ID: 7315855491 Enrollment ID: I20130709000231 |
| Provider Name | Darice M Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043479892 PECOS PAC ID: 0042453607 Enrollment ID: I20130829000271 |
| Provider Name | Kellye N Singletary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063433324 PECOS PAC ID: 5698918480 Enrollment ID: I20130829000722 |
| Provider Name | Zahra T Alimohammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114248978 PECOS PAC ID: 5799003133 Enrollment ID: I20150414001842 |
| Provider Name | Gracie Adkisson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063799856 PECOS PAC ID: 6002107257 Enrollment ID: I20160620001831 |
| Provider Name | Priyanka Chava |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063776656 PECOS PAC ID: 0446490924 Enrollment ID: I20170113000067 |
| Provider Name | Ashley A Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972021673 PECOS PAC ID: 6204183130 Enrollment ID: I20180723003125 |
| Provider Name | Lindsay Fara Dennington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114400728 PECOS PAC ID: 6608128491 Enrollment ID: I20181005000252 |
| Provider Name | Jessica Christine Reddin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801379573 PECOS PAC ID: 9032461793 Enrollment ID: I20181008000553 |
| Provider Name | Agather Auma Onyango |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194367813 PECOS PAC ID: 5092140830 Enrollment ID: I20200124000189 |
| Provider Name | Alvine Metoho-eke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306461934 PECOS PAC ID: 4880747385 Enrollment ID: I20200622000601 |
| Provider Name | Jillian Kaitlyn Hodgkiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265703839 PECOS PAC ID: 2567876105 Enrollment ID: I20210122001029 |
| Provider Name | Diane Lynn Cruseturner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164525549 PECOS PAC ID: 5496705196 Enrollment ID: I20210128001757 |
| Provider Name | Robin Amy White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134418338 PECOS PAC ID: 7517366834 Enrollment ID: I20210518002946 |
| Provider Name | Laci Northam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659040657 PECOS PAC ID: 2264839737 Enrollment ID: I20210927000431 |
| Provider Name | Tiffaney Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770096232 PECOS PAC ID: 0042566044 Enrollment ID: I20220107001617 |
| Provider Name | Valerie Michelle Vaughn-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154929735 PECOS PAC ID: 3577941723 Enrollment ID: I20220601000328 |
| Provider Name | Dustin Ash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255030995 PECOS PAC ID: 5496129181 Enrollment ID: I20230321000036 |
| Provider Name | Mindy Mcbride |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174223960 PECOS PAC ID: 3072988310 Enrollment ID: I20230419000040 |
| Provider Name | Misty Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003503418 PECOS PAC ID: 8022474410 Enrollment ID: I20230509001666 |
| Provider Name | Carrie Leafblad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417620444 PECOS PAC ID: 0840649174 Enrollment ID: I20231212004019 |
| Provider Name | Patrick T Quinten |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1366808537 PECOS PAC ID: 8426408352 Enrollment ID: I20231219001191 |
| Provider Name | Martha B Bibler |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1174829543 PECOS PAC ID: 4082064928 Enrollment ID: I20231219001534 |
| Provider Name | Marissa Norman |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1649726779 PECOS PAC ID: 4385094242 Enrollment ID: I20231219002343 |
| Provider Name | Amy Weems |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700423928 PECOS PAC ID: 9931559804 Enrollment ID: I20231219002756 |
| Provider Name | Brandi Russell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669917944 PECOS PAC ID: 6800246778 Enrollment ID: I20231219002987 |
| Provider Name | Tramaine Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245800275 PECOS PAC ID: 9931559812 Enrollment ID: I20231219003224 |
| Provider Name | Stephanie Hartline |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1013467778 PECOS PAC ID: 8022468867 Enrollment ID: I20231220001537 |
| Provider Name | Leslye Vaughan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376008391 PECOS PAC ID: 1951751635 Enrollment ID: I20231220003655 |
| Provider Name | Dylan Phillips |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1568946606 PECOS PAC ID: 0648620377 Enrollment ID: I20231221001234 |
| Provider Name | Rod R Ryder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164580684 PECOS PAC ID: 9436509171 Enrollment ID: I20231221001831 |
| Provider Name | Joey Glenn Garner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194881805 PECOS PAC ID: 2961852512 Enrollment ID: I20231222002303 |
| Provider Name | David Kistenmacher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427565225 PECOS PAC ID: 0143670455 Enrollment ID: I20231228003800 |
| Provider Name | Joni Mondy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619628211 PECOS PAC ID: 6002266319 Enrollment ID: I20231228003946 |
| Provider Name | Mitzi M Harrington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871862292 PECOS PAC ID: 0143670372 Enrollment ID: I20231229000840 |
| Provider Name | Jeffery Holt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609383777 PECOS PAC ID: 7618327859 Enrollment ID: I20231229001198 |
| Provider Name | Carrie Kirkham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912683749 PECOS PAC ID: 1254781438 Enrollment ID: I20231229002770 |
| Provider Name | Ashley Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588428304 PECOS PAC ID: 0446694913 Enrollment ID: I20240223000879 |
| Provider Name | Michael Chad Chiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720846066 PECOS PAC ID: 9436598331 Enrollment ID: I20240411001659 |
| Provider Name | Jessica Mcclain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588406755 PECOS PAC ID: 3274076526 Enrollment ID: I20240614003543 |
Miracle Professional Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 E Moore Ave Ste 214, Terrell, TX 75160 Phone: 972-953-8542 | |
Access 2 Recovery, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 W Moore Ave, Terrell, TX 75160 Phone: 972-210-7504 | |
Terrell State Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 E Brin Street, Terrell, TX 75160 Phone: 972-551-8826 Fax: 972-551-8513 | |
Lakes Regional Mhmr Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Airport Rd, Terrell, TX 75160 Phone: 972-388-2000 Fax: 972-524-1002 | |
Lakes Regional Community Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Airport Rd, Terrell, TX 75160 Phone: 972-524-4159 Fax: 972-524-1002 | |
Our Folks Ghc Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8578 County Road 301, Terrell, TX 75160 Phone: 469-475-1238 | |
Lakes Regional Community Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Airport Rd, Terrell, TX 75160 Phone: 972-524-4159 Fax: 972-388-2009 |