| Selah Counseling Service Pllc | |
|
1615 W Abram St Arlington TX 76013-1788 | |
| (214) 498-5369 | |
| Not Available |
| Full Name | Selah Counseling Service Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1615 W Abram St, Arlington, Texas |
| Authorized Official Name and Position | Jade Gianakopoulos (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9372060377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selah Counseling Service Pllc 1615 W Abram St Arlington TX 76013-1788 Ph: (214) 498-5369 | Selah Counseling Service Pllc 1615 W Abram St Arlington TX 76013-1788 Ph: (214) 498-5369 |
| NPI Number | 1912421421 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4789950627 |
|---|---|
| Medicare Enrollment ID | O20171020002657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912421421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 28389 (Texas) | Primary |
| Provider Name | Theresa Bayley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689994030 PECOS PAC ID: 5698041531 Enrollment ID: I20171020002817 |
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