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1700 Covemeadow Dr Arlington TX 76012-5407 | |
| (972) 836-9387 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1700 Covemeadow Dr, Arlington, Texas |
| Authorized Official Name and Position | Andres Diosdado (PRESIDENT) |
| Authorized Official Contact | 9405945418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1700 Covemeadow Dr Arlington TX 76012-5407 Ph: (972) 836-9387 | 1700 Covemeadow Dr Arlington TX 76012-5407 Ph: (972) 836-9387 |
| NPI Number | 1780976076 |
|---|---|
| Provider Enumeration Date | 05/05/2011 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Medicare PECOS PAC ID | 1759722606 |
|---|---|
| Medicare Enrollment ID | O20240509003250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780976076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Jennifer A Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649577172 PECOS PAC ID: 2062791379 Enrollment ID: I20161109000858 |
| Provider Name | Haydee Sierra-santos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982385936 PECOS PAC ID: 2769844893 Enrollment ID: I20230821004182 |
| Provider Name | Angel Manuel Almeraz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639867302 PECOS PAC ID: 1557714615 Enrollment ID: I20240125001946 |
| Provider Name | Rachel Anne Preston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730670142 PECOS PAC ID: 4183065030 Enrollment ID: I20240509003405 |
| Provider Name | Carissma Hughes-valentine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134767171 PECOS PAC ID: 9436572534 Enrollment ID: I20240528000324 |
| Provider Name | Andrea Leigh Boen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053039727 PECOS PAC ID: 1951840339 Enrollment ID: I20240829001342 |
| Provider Name | Beth Faulkner Jewell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437325495 PECOS PAC ID: 7315486693 Enrollment ID: I20240830000346 |
| Provider Name | Juliann Ebelherr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922348747 PECOS PAC ID: 6002356987 Enrollment ID: I20240905004211 |
| Provider Name | Valerie Leanne Gillen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124721972 PECOS PAC ID: 1052851995 Enrollment ID: I20240906001288 |
| Provider Name | Naquasha Riser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619578614 PECOS PAC ID: 3577003433 Enrollment ID: I20240906002277 |
| Provider Name | Patricia Monterrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336820950 PECOS PAC ID: 0042750853 Enrollment ID: I20240907000703 |
| Provider Name | Mark A Rhodes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750468385 PECOS PAC ID: 1850832064 Enrollment ID: I20240916000845 |
| Provider Name | Karen Denise Bostick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255477766 PECOS PAC ID: 0547793259 Enrollment ID: I20241101000982 |
| Provider Name | Robyn Krystal Urive |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710683628 PECOS PAC ID: 6901339639 Enrollment ID: I20241101001504 |
| Provider Name | Amanda Michelle Tindell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912691775 PECOS PAC ID: 9931633203 Enrollment ID: I20241108001287 |
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