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5750 Genesis Ct Ste 135 Frisco TX 75034-4229 | |
| (425) 686-5631 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 5750 Genesis Ct Ste 135, Frisco, Texas |
| Authorized Official Name and Position | Lisa Anne Delaplace (OWNER) |
| Authorized Official Contact | 4252810613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2912 Saltwood Ct Celina TX 75009-6584 Ph: (425) 281-0613 | 5750 Genesis Ct Ste 135 Frisco TX 75034-4229 Ph: (425) 686-5631 |
| NPI Number | 1841840873 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/07/2022 |
| Medicare PECOS PAC ID | 4082092705 |
|---|---|
| Medicare Enrollment ID | O20220608000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841840873 | NPI | - | NPPES |
| 217035600 | Medicaid | WA |
| Provider Name | Lisa A Delaplace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447659511 PECOS PAC ID: 5991183618 Enrollment ID: I20220608000214 |
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