| Permian Basin Community Centers For Mental Health & Mental Retardation | |
|
401 E Illinois Ave Ste 200 Midland TX 79701 | |
| (432) 570-3333 | |
| (432) 570-3346 |
| Full Name | Permian Basin Community Centers For Mental Health & Mental Retardation |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 E Illinois Ave, Midland, Texas |
| Authorized Official Name and Position | Ramona Thomas (DEPUTY EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4325703333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Permian Basin Community Centers For Mental Health & Mental Retardation 401 E Illinois Ave Ste 400 Midland TX 79701 Ph: (432) 570-3333 | Permian Basin Community Centers For Mental Health & Mental Retardation 401 E Illinois Ave Ste 200 Midland TX 79701 Ph: (432) 570-3333 |
| NPI Number | 1700976453 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 07/15/2011 |
| Medicare PECOS PAC ID | 8426955865 |
|---|---|
| Medicare Enrollment ID | O20040427000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700976453 | NPI | - | NPPES |
| Provider Name | Susan S Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063913226 PECOS PAC ID: 6002879020 Enrollment ID: I20041110000285 |
| Provider Name | Donna F Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487767968 PECOS PAC ID: 5991730772 Enrollment ID: I20050929001014 |
| Provider Name | Shailesh Jain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215922802 PECOS PAC ID: 0143244764 Enrollment ID: I20060123000618 |
| Provider Name | Pamela J Petersen-crair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023127271 PECOS PAC ID: 8820004278 Enrollment ID: I20060222000831 |
| Provider Name | Linda K Fortmeier-saucier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811912223 PECOS PAC ID: 4183622079 Enrollment ID: I20061202000059 |
| Provider Name | Roddy M Strobel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669473112 PECOS PAC ID: 8527156686 Enrollment ID: I20071127000127 |
| Provider Name | Nilima N Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639250228 PECOS PAC ID: 4486730819 Enrollment ID: I20080326000511 |
| Provider Name | Avrim Brett Fishkind |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093727943 PECOS PAC ID: 2466539804 Enrollment ID: I20080409000300 |
| Provider Name | Kristin E Mondy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265459762 PECOS PAC ID: 9436181575 Enrollment ID: I20081230000347 |
| Provider Name | Vani Selvan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689869117 PECOS PAC ID: 0345305280 Enrollment ID: I20090210000427 |
| Provider Name | Gary D Lefkof |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356570253 PECOS PAC ID: 9537207949 Enrollment ID: I20091104000721 |
| Provider Name | Matthew D Faubion |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295769743 PECOS PAC ID: 2860532553 Enrollment ID: I20091210000156 |
| Provider Name | Lisamar Maldonado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316127467 PECOS PAC ID: 2163555970 Enrollment ID: I20100730000539 |
| Provider Name | Nadine R Baptiste |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285811752 PECOS PAC ID: 6608914254 Enrollment ID: I20100818000880 |
| Provider Name | Anamari C Milam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043252281 PECOS PAC ID: 7012109606 Enrollment ID: I20101014000974 |
| Provider Name | Suthep Arora |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750564068 PECOS PAC ID: 9234307422 Enrollment ID: I20110713000631 |
| Provider Name | Antoinette E Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487921854 PECOS PAC ID: 7911160924 Enrollment ID: I20120531000124 |
| Provider Name | Justin James Parrott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053677179 PECOS PAC ID: 5597921924 Enrollment ID: I20120730000285 |
| Provider Name | Anita Chellappah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235444092 PECOS PAC ID: 0143474486 Enrollment ID: I20130214000009 |
| Provider Name | Cesar De Paz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568620672 PECOS PAC ID: 1254570294 Enrollment ID: I20130624000034 |
| Provider Name | Svetlana S Sembrano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467612036 PECOS PAC ID: 8628217502 Enrollment ID: I20130626000104 |
| Provider Name | Lyle B Montgomery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730208158 PECOS PAC ID: 7315855491 Enrollment ID: I20130709000231 |
| Provider Name | Debbie Villarreal Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275854622 PECOS PAC ID: 8224270103 Enrollment ID: I20130805000819 |
| 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 | Denise Ann Canchola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437267747 PECOS PAC ID: 2567598741 Enrollment ID: I20140125000262 |
| Provider Name | Martin Ortega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982991899 PECOS PAC ID: 3678791340 Enrollment ID: I20140822000594 |
| Provider Name | Damaris Chukwura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992100903 PECOS PAC ID: 8426374364 Enrollment ID: I20150311002033 |
| Provider Name | Mark Luley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881815462 PECOS PAC ID: 3678709961 Enrollment ID: I20150424001620 |
| Provider Name | Aaron J Alaniz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851684039 PECOS PAC ID: 0547573354 Enrollment ID: I20150723007146 |
| Provider Name | Natalia Kazakevich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447570999 PECOS PAC ID: 6608180542 Enrollment ID: I20150805008027 |
| Provider Name | Adelina M Saldivar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699155606 PECOS PAC ID: 4688833239 Enrollment ID: I20150820010149 |
| Provider Name | Odochi P Onungwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811373673 PECOS PAC ID: 4183790678 Enrollment ID: I20151125000322 |
| Provider Name | John Kenny |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750449732 PECOS PAC ID: 9739102716 Enrollment ID: I20151217000691 |
| Provider Name | Peter Nyanegweso Moenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518325380 PECOS PAC ID: 3173828282 Enrollment ID: I20160229000818 |
| Provider Name | Nicolas D Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023243995 PECOS PAC ID: 9032387576 Enrollment ID: I20160330001073 |
| Provider Name | Flavio Casoy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992032908 PECOS PAC ID: 7214106657 Enrollment ID: I20160427000281 |
| Provider Name | Sandra O Kolapo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568834984 PECOS PAC ID: 1052605680 Enrollment ID: I20160804001903 |
| Provider Name | Tiffany Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669727137 PECOS PAC ID: 4880839448 Enrollment ID: I20161114002060 |
| Provider Name | Brie Elizabeth Alford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447546387 PECOS PAC ID: 5799926739 Enrollment ID: I20170208000040 |
| Provider Name | Amara S Chudhary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326272279 PECOS PAC ID: 6800038720 Enrollment ID: I20170619001803 |
| Provider Name | Mary J Hulsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467755769 PECOS PAC ID: 7719161769 Enrollment ID: I20170703000108 |
| Provider Name | Mili M Khandheria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295094043 PECOS PAC ID: 4688947302 Enrollment ID: I20170831001718 |
| Provider Name | Moni Baidya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174767602 PECOS PAC ID: 1557590932 Enrollment ID: I20170905001738 |
| Provider Name | Zian Ijang Takwi Omene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619481835 PECOS PAC ID: 7113284860 Enrollment ID: I20171205001616 |
| Provider Name | Susan Zink |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174843510 PECOS PAC ID: 5092993824 Enrollment ID: I20180117001120 |
| Provider Name | Hector L Rivera Reyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457583585 PECOS PAC ID: 9739302340 Enrollment ID: I20180702000570 |
| Provider Name | Cordelia M Odunayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306325790 PECOS PAC ID: 7719239854 Enrollment ID: I20181017003058 |
| Provider Name | Andre J Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023162559 PECOS PAC ID: 6406917285 Enrollment ID: I20181219002884 |
| Provider Name | Carlos Alicea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114331063 PECOS PAC ID: 5395083216 Enrollment ID: I20190219000128 |
| Provider Name | Rama V Thyagarajan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003886151 PECOS PAC ID: 1658302831 Enrollment ID: I20191024002773 |
| Provider Name | Camett M Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326517509 PECOS PAC ID: 0042648743 Enrollment ID: I20200311001997 |
| Provider Name | Nkem Okoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972195840 PECOS PAC ID: 7012325079 Enrollment ID: I20210413001288 |
| Provider Name | Katie Amanda Corkill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568959336 PECOS PAC ID: 5890041677 Enrollment ID: I20210812002006 |
| Provider Name | Wilfred Suleiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861065500 PECOS PAC ID: 7214335017 Enrollment ID: I20211008000814 |
| Provider Name | Melinda Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841860517 PECOS PAC ID: 3678977543 Enrollment ID: I20211019002584 |
| Provider Name | Mikkia Gould |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114691623 PECOS PAC ID: 2567853898 Enrollment ID: I20211221002982 |
| Provider Name | Patricia Alonzo-prasher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093878472 PECOS PAC ID: 6305293796 Enrollment ID: I20231127001748 |
| Provider Name | Ashley Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124614805 PECOS PAC ID: 8426406695 Enrollment ID: I20231128003443 |
| Provider Name | Jeanette Fierro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639854003 PECOS PAC ID: 2062860190 Enrollment ID: I20231129002102 |
| Provider Name | Gloria Beth Ramirez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578277208 PECOS PAC ID: 9032566864 Enrollment ID: I20231129003527 |
| Provider Name | Carron Shellenberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699835462 PECOS PAC ID: 5395193361 Enrollment ID: I20231201000004 |
| Provider Name | Victor Hugo Hernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356886881 PECOS PAC ID: 2264834803 Enrollment ID: I20231206000374 |
| Provider Name | Michelle Mcclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619608924 PECOS PAC ID: 1850364902 Enrollment ID: I20240625002694 |
Permian Basin Community Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 N Carver St, Midland, TX 79701 Phone: 432-570-3390 Fax: 432-570-3375 | |
Rebuilders Of Hope, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 N Garfield St, Suite 245, Midland, TX 79705 Phone: 432-634-8509 Fax: 432-684-7671 | |
Permian Basin Community Centers For Mhmr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Illinois Ave, Ste 400, Midland, TX 79701 Phone: 432-570-3333 Fax: 432-570-3346 | |
Archway Suppport, Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 W Texas Ave, Midland, TX 79701 Phone: 432-682-2724 Fax: 432-682-2725 | |
Neurosolutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 W Illinois Ave Ste 212, Midland, TX 79703 Phone: 432-413-2369 | |