| Northeast Counseling Center, Pllc | |
|
12915 Jones Maltsberger Rd Ste 201 San Antonio TX 78247-4540 | |
| (210) 404-4317 | |
| (210) 817-8722 |
| Full Name | Northeast Counseling Center, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 12915 Jones Maltsberger Rd Ste 201, San Antonio, Texas |
| Authorized Official Name and Position | Andrea Aguero Cox (LCSW) |
| Authorized Official Contact | 9032834405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Counseling Center, Pllc 12915 Jones Maltsberger Rd Ste 201 San Antonio TX 78247-4540 Ph: (210) 404-4317 | Northeast Counseling Center, Pllc 12915 Jones Maltsberger Rd Ste 201 San Antonio TX 78247-4540 Ph: (210) 404-4317 |
| NPI Number | 1477198141 |
|---|---|
| Provider Enumeration Date | 11/16/2019 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 3971930942 |
|---|---|
| Medicare Enrollment ID | O20200304000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477198141 | NPI | - | NPPES |
| 408501101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Andrea Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366744591 PECOS PAC ID: 7810170222 Enrollment ID: I20110323000070 |
| Provider Name | Chenoa Mari Moten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821450107 PECOS PAC ID: 5092192468 Enrollment ID: I20220525000039 |
| Provider Name | Clifford Charles Cantu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467162149 PECOS PAC ID: 5698145332 Enrollment ID: I20221221002159 |
| Provider Name | Elizabeth Renae Duke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316448970 PECOS PAC ID: 7113378688 Enrollment ID: I20240109002602 |
| Provider Name | Tanya Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891531224 PECOS PAC ID: 8820537947 Enrollment ID: I20240903001747 |
| Provider Name | Ralph Ray Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386426179 PECOS PAC ID: 6305378407 Enrollment ID: I20241014004836 |
| Provider Name | Elizabeth Ransom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295161800 PECOS PAC ID: 5799112769 Enrollment ID: I20241113004768 |
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