| Salt And Light Psychological Services Pllc | |
|
1901 Central Dr Ste 160 Bedford TX 76021-5823 | |
| (682) 289-0546 | |
| (855) 658-1426 |
| Full Name | Salt And Light Psychological Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1901 Central Dr, Bedford, Texas |
| Authorized Official Name and Position | Lydia Sagar (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6822890546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salt And Light Psychological Services Pllc 1901 Central Dr Ste 160 Bedford TX 76021-5823 Ph: (682) 289-0546 | Salt And Light Psychological Services Pllc 1901 Central Dr Ste 160 Bedford TX 76021-5823 Ph: (682) 289-0546 |
| NPI Number | 1003583972 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 3072908565 |
|---|---|
| Medicare Enrollment ID | O20220321000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003583972 | NPI | - | NPPES |
| Provider Name | Lydia Sagar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407293137 PECOS PAC ID: 9234372830 Enrollment ID: I20130829000770 |
| Provider Name | Abigail Justine Goode |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316660442 PECOS PAC ID: 1153707633 Enrollment ID: I20221006002313 |
| Provider Name | David W Labrie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851362362 PECOS PAC ID: 9436397254 Enrollment ID: I20221117002369 |
| Provider Name | Kaeli Evelyn Cantwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790479327 PECOS PAC ID: 1557716537 Enrollment ID: I20231011001215 |
| Provider Name | Carlos Adiax Hurtado-lopez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174775787 PECOS PAC ID: 0446608707 Enrollment ID: I20231127002044 |
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