| Senior Psychological Care Sa I, Llc | |
|
4635 Southwest Fwy Ste 635 Houston TX 77027-7112 | |
| (713) 850-0049 | |
| (713) 627-7302 |
| Full Name | Senior Psychological Care Sa I, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4635 Southwest Fwy Ste 635, Houston, Texas |
| Authorized Official Name and Position | Randall J. Frapart (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7138500049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Psychological Care Sa I, Llc 4635 Southwest Fwy Ste 635 Houston TX 77027-7112 Ph: (713) 850-0049 | Senior Psychological Care Sa I, Llc 4635 Southwest Fwy Ste 635 Houston TX 77027-7112 Ph: (713) 850-0049 |
| NPI Number | 1205122355 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 12/13/2018 |
| Medicare PECOS PAC ID | 5193999860 |
|---|---|
| Medicare Enrollment ID | O20111114000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205122355 | NPI | - | NPPES |
| 0007WZ | Other | TX | BCBS TX |
| 292958002 | Medicaid | TX | |
| 292958003 | Medicaid | TX | |
| DS2666 | Other | TX | RR MCR HARRIS |
| 292958001 | Medicaid | TX |
| Provider Name | Twyla Oliva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861404550 PECOS PAC ID: 2567412802 Enrollment ID: I20050125000694 |
| Provider Name | Christen D Leal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144426628 PECOS PAC ID: 3870519606 Enrollment ID: I20051020000484 |
| Provider Name | Amanda R Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598945396 PECOS PAC ID: 8527142637 Enrollment ID: I20080228000264 |
| Provider Name | Amy Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053581637 PECOS PAC ID: 3375606874 Enrollment ID: I20090109000256 |
| Provider Name | Howard E Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497819676 PECOS PAC ID: 9133270101 Enrollment ID: I20090707000435 |
| Provider Name | Irma S Beltran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609042340 PECOS PAC ID: 2365582905 Enrollment ID: I20091212000107 |
| Provider Name | Manuel R Emperador |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649682790 PECOS PAC ID: 7416179296 Enrollment ID: I20141111001267 |
| Provider Name | Cynthia Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801070693 PECOS PAC ID: 8123334919 Enrollment ID: I20150824001733 |
| Provider Name | Roberto C Montes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639523855 PECOS PAC ID: 8628360674 Enrollment ID: I20160712000993 |
| Provider Name | Jennifer Elizabeth Rawley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417255423 PECOS PAC ID: 3971899592 Enrollment ID: I20160908001192 |
| Provider Name | Celia M Melecio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740829696 PECOS PAC ID: 3779918776 Enrollment ID: I20200122000867 |
| Provider Name | Rebecca R Kalomiris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407383821 PECOS PAC ID: 0840625851 Enrollment ID: I20200122001350 |
| Provider Name | Anthony Gacita Vinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346627197 PECOS PAC ID: 3476832270 Enrollment ID: I20200721004125 |
| Provider Name | Chatone F Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285226050 PECOS PAC ID: 1153736137 Enrollment ID: I20210225001572 |
| Provider Name | Shari Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598307639 PECOS PAC ID: 5395171789 Enrollment ID: I20210413001550 |
| Provider Name | Leonid Royzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700100435 PECOS PAC ID: 6204238769 Enrollment ID: I20210707001940 |
| Provider Name | Eric Houin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285965236 PECOS PAC ID: 4385670777 Enrollment ID: I20220127002329 |
| Provider Name | Beyinah Y Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871078659 PECOS PAC ID: 4082000849 Enrollment ID: I20220404000212 |
| Provider Name | Tenisha Hunter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497381628 PECOS PAC ID: 8921487224 Enrollment ID: I20220616000950 |
| Provider Name | Samuel A Wolde |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275173536 PECOS PAC ID: 9739503426 Enrollment ID: I20220908001888 |
| Provider Name | Samantha Schoonover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609422401 PECOS PAC ID: 3274918776 Enrollment ID: I20220920002039 |
| Provider Name | Stephanie Sherelle Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003521139 PECOS PAC ID: 8123483633 Enrollment ID: I20230504002017 |
| Provider Name | Coral Harriman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417373069 PECOS PAC ID: 7517208895 Enrollment ID: I20230608002526 |
| Provider Name | Julie Bolanos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689081614 PECOS PAC ID: 8921469636 Enrollment ID: I20230727002596 |
| 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 | Ruby Mora Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437720182 PECOS PAC ID: 0143668889 Enrollment ID: I20240401002485 |
| Provider Name | Vanessa E Delgado-ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518246925 PECOS PAC ID: 6002236262 Enrollment ID: I20240402002211 |
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