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416 E Main St Denison TX 75021-2822 | |
| (903) 465-6344 | |
| (903) 465-5943 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 416 E Main St, Denison, Texas |
| Authorized Official Name and Position | Dianna L Dean (CEO) |
| Authorized Official Contact | 9034656344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
416 E Main St Denison TX 75021-2822 Ph: (903) 465-6344 | 416 E Main St Denison TX 75021-2822 Ph: (903) 465-6344 |
| NPI Number | 1699835991 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 07/01/2015 |
| Medicare PECOS PAC ID | 1052759859 |
|---|---|
| Medicare Enrollment ID | O20240328003740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699835991 | NPI | - | NPPES |
| 2808941-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 16757 (Texas) | Primary |
| 101YM0800X | Counselor - Mental Health | 3066 (Oklahoma) | Secondary |
| 104100000X | Social Worker | 26213 (Texas) | Secondary |
| Provider Name | Dianna L Dean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477748978 PECOS PAC ID: 3870931678 Enrollment ID: I20240503001847 |
| Provider Name | Suzanne Rose Draper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043515760 PECOS PAC ID: 5991247413 Enrollment ID: I20240611003618 |
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