- Medicare Mental Health Clinic in Longview, TX

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is a medicare enrolled mental health clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Longview, Texas. The current practice location for is 1107 E Marshall Ave, Longview, Texas. For appointments, you can reach them via phone at (903) 758-2610. The mailing address for is 1107 E Marshall Ave, Longview, Texas and phone number is (903) 758-2610.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1942269493. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (903) 758-2610.

Contact Information

1107 E Marshall Ave
Longview
TX 75601-5602
(903) 758-2610
(903) 758-3124

Map and Direction


Mental Health Clinic Profile

Full Name
SpecialityClinic/Center
Location1107 E Marshall Ave, Longview, Texas
Authorized Official Name and PositionTimothy Chad Jones (CEO)
Authorized Official Contact9037582610
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

1107 E Marshall Ave
Longview
TX 75601-5602

Ph: (903) 758-2610
1107 E Marshall Ave
Longview
TX 75601-5602

Ph: (903) 758-2610

NPI Details:

NPI Number1942269493
Provider Enumeration Date03/22/2006
Last Update Date06/12/2024
Certification Date06/12/2024

Medicare PECOS Information:

Medicare PECOS PAC ID1254367766
Medicare Enrollment IDO20050714001046

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942269493NPI-NPPES
081382603MedicaidTX
111796203MedicaidTX
111796204MedicaidTX
180330601MedicaidTX
111796201MedicaidTX
183824501MedicaidTX
081382602MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 11004 (Texas)Secondary
1223G0001XDentist - General Practice 19170 (Texas)Secondary
171M00000XCase Manager/care Coordinator (* (Not Available))Secondary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Secondary
251B00000XCase Management (* (Not Available))Secondary
261QA0005XClinic/center - Ambulatory Family Planning Facility (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary
261QR0405XClinic/center - Rehabilitation, Substance Use Disorder (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameEleazar Vera
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1407822299
PECOS PAC ID: 2062409923
Enrollment ID: I20040430000732
Provider NameJerome Clayton Young
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1518958230
PECOS PAC ID: 1850382821
Enrollment ID: I20040519000757
Provider NameAnnette O Okpeki
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1699774489
PECOS PAC ID: 0648261099
Enrollment ID: I20040524000406
Provider NameJanet Kelley
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1225005531
PECOS PAC ID: 8527041193
Enrollment ID: I20040612000698
Provider NameDonna C Britton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568454569
PECOS PAC ID: 4486638087
Enrollment ID: I20040614000171
Provider NameSabrina Benefield Castle
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1023085925
PECOS PAC ID: 4880664614
Enrollment ID: I20040729000284
Provider NameMelissa S Slovak Tucker
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1477540003
PECOS PAC ID: 7214909696
Enrollment ID: I20040806000852
Provider NameJames E Mauldin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1306813662
PECOS PAC ID: 3870547813
Enrollment ID: I20050311000522
Provider NameTheresa Martin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1255308508
PECOS PAC ID: 3173577137
Enrollment ID: I20050311000695
Provider NameLynn M Brazell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1356318273
PECOS PAC ID: 7113972902
Enrollment ID: I20050315000246
Provider NameFrancis J Tibiletti
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1245207638
PECOS PAC ID: 5890740237
Enrollment ID: I20050317000875
Provider NameWendy Markowitz
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1659477222
PECOS PAC ID: 3870538754
Enrollment ID: I20050621001255
Provider NameMark L Lobaugh
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1710984091
PECOS PAC ID: 7719874742
Enrollment ID: I20050711000520
Provider NameGeorge M Kingsley
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1104819556
PECOS PAC ID: 2163454166
Enrollment ID: I20050914000349
Provider NameYasser F Zeid
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1548369424
PECOS PAC ID: 1850325663
Enrollment ID: I20050921000713
Provider NameRoy A Mcclintock
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1437217494
PECOS PAC ID: 2769446293
Enrollment ID: I20051123000403
Provider NameGloria S Gray
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831237775
PECOS PAC ID: 9638191166
Enrollment ID: I20051228000328
Provider NameAngela D Houghton
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1407840606
PECOS PAC ID: 7911914551
Enrollment ID: I20060307000636
Provider NameKristen N Innes
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1457327884
PECOS PAC ID: 5890772677
Enrollment ID: I20060322000576
Provider NameCharles Keith Grisham
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1356531180
PECOS PAC ID: 1355351040
Enrollment ID: I20060425000744
Provider NameAnita J Chin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1730110446
PECOS PAC ID: 3375547805
Enrollment ID: I20060914000108
Provider NameDoreen A Moser
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1194721944
PECOS PAC ID: 3274531918
Enrollment ID: I20061113000534
Provider NameEddie P Kemper
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1932170602
PECOS PAC ID: 3072511542
Enrollment ID: I20061116000199
Provider NameMichael E Esedebe
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1952410037
PECOS PAC ID: 1850391871
Enrollment ID: I20061221000515
Provider NameRicky A Paul
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1073699500
PECOS PAC ID: 3577546696
Enrollment ID: I20070222000254
Provider NameJohn H Shum
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1861616047
PECOS PAC ID: 1153421128
Enrollment ID: I20070705000586
Provider NameJaclyn P Gilliam
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1154483113
PECOS PAC ID: 7911960117
Enrollment ID: I20071005000428
Provider NameRobert B Thomas
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1740310036
PECOS PAC ID: 2365529252
Enrollment ID: I20080402000418
Provider NameCarrie D Hinton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912914151
PECOS PAC ID: 6709956709
Enrollment ID: I20080603000345
Provider NameKim M Schaus
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1851445340
PECOS PAC ID: 6800957929
Enrollment ID: I20081209000055
Provider NameAnnmarie M Ledley
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1295731016
PECOS PAC ID: 0749261840
Enrollment ID: I20090604000407
Provider NameRalph J Turner
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1013950997
PECOS PAC ID: 2961436928
Enrollment ID: I20090727000065
Provider NamePaul L Lin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1497722714
PECOS PAC ID: 7113066200
Enrollment ID: I20091202000737
Provider NameMargaret L Morton
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1972570539
PECOS PAC ID: 5294874384
Enrollment ID: I20091202000746
Provider NameRobert M Wheeler
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1851368831
PECOS PAC ID: 0840293403
Enrollment ID: I20091202000748
Provider NameLinda C Boggs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164499661
PECOS PAC ID: 9830238732
Enrollment ID: I20091207000415
Provider NameChristopher A Yancey
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1346217783
PECOS PAC ID: 2163562752
Enrollment ID: I20091211000347
Provider NamePhilip S Hunter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700893039
PECOS PAC ID: 8628110343
Enrollment ID: I20100120000155
Provider NameBernardine Amadi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487885901
PECOS PAC ID: 1850421280
Enrollment ID: I20100611000297
Provider NameRamon G Villafria
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619997319
PECOS PAC ID: 8426019084
Enrollment ID: I20100618000689
Provider NameMark Allison Little
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1699772863
PECOS PAC ID: 7012014707
Enrollment ID: I20100805001032
Provider NameChristopher Norman Mason
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1215924832
PECOS PAC ID: 7315919552
Enrollment ID: I20100817000076
Provider NameJohn M Mckenzie
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366547846
PECOS PAC ID: 5395860704
Enrollment ID: I20100908001042
Provider NameJoseph L Petty
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1649461211
PECOS PAC ID: 1557486404
Enrollment ID: I20100915000587
Provider NameAlison A Rodriguez
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1942349261
PECOS PAC ID: 2365505690
Enrollment ID: I20101029000597
Provider NameRachel Ann Everson
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1992936603
PECOS PAC ID: 0648469148
Enrollment ID: I20110114000412
Provider NameMarcy J Hall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548229990
PECOS PAC ID: 6709062417
Enrollment ID: I20110513000529
Provider NameSylyna G Kennedy
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1750421095
PECOS PAC ID: 6507034782
Enrollment ID: I20110713000503
Provider NamePatricia Brooke Simmons
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346556420
PECOS PAC ID: 0547430928
Enrollment ID: I20110822000262
Provider NameAric C Gillen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1720285158
PECOS PAC ID: 3870765738
Enrollment ID: I20111019000245
Provider NameThiendella Diagne
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1538330352
PECOS PAC ID: 5799851937
Enrollment ID: I20111116000900
Provider NameDennis C Eisenberg
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1851382154
PECOS PAC ID: 1052570587
Enrollment ID: I20120302000045
Provider NameOmar Robert Sarmini
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1417945262
PECOS PAC ID: 6709814338
Enrollment ID: I20120314000330
Provider NameHarry P Froeschke
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1710975560
PECOS PAC ID: 8628006251
Enrollment ID: I20120412000317
Provider NameGhassan N Fanous
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1013021146
PECOS PAC ID: 3375513872
Enrollment ID: I20120416000347
Provider NameFelicia K Coleman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609132521
PECOS PAC ID: 9133381924
Enrollment ID: I20120423000755
Provider NameWendy Mckinnon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790051548
PECOS PAC ID: 7517113400
Enrollment ID: I20120808000743
Provider NameT. Lynne Haygood-kane
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1750394904
PECOS PAC ID: 7810885514
Enrollment ID: I20120910000405
Provider NameJulia Ann Russell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982954566
PECOS PAC ID: 6406005131
Enrollment ID: I20121012000362
Provider NameJavier Garcia
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1932309838
PECOS PAC ID: 8729168695
Enrollment ID: I20130207000398
Provider NameAlexandra Dionne Kittrell
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1801134085
PECOS PAC ID: 2769629252
Enrollment ID: I20130430000237
Provider NameKhoshunda M Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093051872
PECOS PAC ID: 0941443873
Enrollment ID: I20130826000270
Provider NameNgan K To
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1902239965
PECOS PAC ID: 7214170539
Enrollment ID: I20130905000170
Provider NameKristi L Saxon
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1922068972
PECOS PAC ID: 7911943691
Enrollment ID: I20131022001413
Provider NameJeffrey William Sewell
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1740288430
PECOS PAC ID: 7719908441
Enrollment ID: I20140529000330
Provider NameVanessa Renee Neiman
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1326356130
PECOS PAC ID: 5294955191
Enrollment ID: I20140926001950
Provider NameJennifer N Smith
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1396151817
PECOS PAC ID: 7810116688
Enrollment ID: I20141124001700
Provider NameCharlene Carter
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1992108120
PECOS PAC ID: 1254653231
Enrollment ID: I20141202000648
Provider NameMonica G Mason
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639574098
PECOS PAC ID: 2860301512
Enrollment ID: I20141229000659
Provider NameNora Eades
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053712547
PECOS PAC ID: 4284952821
Enrollment ID: I20150413000300
Provider NameTracy Lanell Hicks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215353651
PECOS PAC ID: 0648592741
Enrollment ID: I20150806012033
Provider NameJavine Mclaughlin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1720026156
PECOS PAC ID: 3072526201
Enrollment ID: I20151023000606
Provider NameMarcus D Turney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144610106
PECOS PAC ID: 5991007577
Enrollment ID: I20160114000142
Provider NameJames Harley Dozier
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1457533101
PECOS PAC ID: 3476611419
Enrollment ID: I20160224001036
Provider NameDana Lynn Shields
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1083073803
PECOS PAC ID: 1951606862
Enrollment ID: I20160301001317
Provider NameGraham Oliver Weaver
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1811156227
PECOS PAC ID: 4587795273
Enrollment ID: I20160322000734
Provider NameZareh H Khachikian
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1215084603
PECOS PAC ID: 3971698069
Enrollment ID: I20160504002547
Provider NameEdward Clark
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1730294232
PECOS PAC ID: 1658661525
Enrollment ID: I20160606000494
Provider NameCharles S Newlin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1639437247
PECOS PAC ID: 8820382963
Enrollment ID: I20160811001687
Provider NameMolly K Mcstravick
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1780940452
PECOS PAC ID: 7618264482
Enrollment ID: I20160921002266
Provider NameEbenezer A Nii-moi
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1396930376
PECOS PAC ID: 9931299062
Enrollment ID: I20161205000792
Provider NameGabrielle Misenheimer
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1356715981
PECOS PAC ID: 4587944681
Enrollment ID: I20161207000841
Provider NamePenny Shavers Blake
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215489935
PECOS PAC ID: 1254613615
Enrollment ID: I20170119000245
Provider NameJacqueline Moran Weber
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1689113060
PECOS PAC ID: 4880979590
Enrollment ID: I20170321000482
Provider NameWendy M Fopay
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851845366
PECOS PAC ID: 4587949607
Enrollment ID: I20170331001498
Provider NameJimmy S Ellis
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1609891795
PECOS PAC ID: 5395805386
Enrollment ID: I20170425000330
Provider NameJocelan Ramsey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659468262
PECOS PAC ID: 0042586406
Enrollment ID: I20171030003330
Provider NameSonja Edmonds
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1487679023
PECOS PAC ID: 5698959997
Enrollment ID: I20171121000410
Provider NameLaura Childress
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104328947
PECOS PAC ID: 8325301211
Enrollment ID: I20180405001488
Provider NameRichard A Joos
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1336148394
PECOS PAC ID: 8628383932
Enrollment ID: I20180613002296
Provider NameCarin Lynnae Wallace
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891288742
PECOS PAC ID: 7113274481
Enrollment ID: I20180717003984
Provider NameObiloh E Egu
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1407831233
PECOS PAC ID: 5092810085
Enrollment ID: I20180917000341
Provider NameRaymond Barron
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1851821920
PECOS PAC ID: 5698012326
Enrollment ID: I20190219000226
Provider NameAngela Caren Fritz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780140194
PECOS PAC ID: 4587905609
Enrollment ID: I20190417002357
Provider NameTiffany Yvette Gardner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790257392
PECOS PAC ID: 8426391319
Enrollment ID: I20190516000851
Provider NameElizabeth Ann Heeb Tidwell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1386023968
PECOS PAC ID: 3476834573
Enrollment ID: I20190615000140
Provider NameJennifer Nicole Skiles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134784838
PECOS PAC ID: 9335472794
Enrollment ID: I20190618000784
Provider NameVijaya Lakshmi Mandalapu
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1730407818
PECOS PAC ID: 5294991022
Enrollment ID: I20190816001623
Provider NameAmit Bhavsar
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1427131986
PECOS PAC ID: 7315379443
Enrollment ID: I20191112000470
Provider NameTracy Hunter Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740405711
PECOS PAC ID: 8628406170
Enrollment ID: I20200316000478
Provider NameBrian Ashford
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1265622732
PECOS PAC ID: 2769664127
Enrollment ID: I20200428000422
Provider NameKimberly Denise Prince
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780205427
PECOS PAC ID: 9739500950
Enrollment ID: I20200526001893
Provider NameRussell F Stanley
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1356797740
PECOS PAC ID: 1355633488
Enrollment ID: I20201013002007
Provider NameKelly D Royce
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1619501608
PECOS PAC ID: 5294148540
Enrollment ID: I20210106002119
Provider NameRana Skaf
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1871562231
PECOS PAC ID: 0648224279
Enrollment ID: I20210302001341
Provider NameCarol Lazell
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1487808457
PECOS PAC ID: 8426459512
Enrollment ID: I20210628000364
Provider NameRoxanne A Lamarre
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1881124642
PECOS PAC ID: 4183026206
Enrollment ID: I20210713000924
Provider NameSandya Athigaman
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1295347326
PECOS PAC ID: 7911304829
Enrollment ID: I20210920002707
Provider NameAshley M Patel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174292056
PECOS PAC ID: 8820495302
Enrollment ID: I20210927000800
Provider NameNermine R Rofael
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1114689890
PECOS PAC ID: 3971991381
Enrollment ID: I20211103001924
Provider NameJacqueline Mojica
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134837792
PECOS PAC ID: 9638548704
Enrollment ID: I20221212002203
Provider NameSandra Martinez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083486989
PECOS PAC ID: 2567810666
Enrollment ID: I20231130000902
Provider NameJeremiah R Taylor
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1366897183
PECOS PAC ID: 3577911544
Enrollment ID: I20231130004092
Provider NameTasha Marie Tovar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982368809
PECOS PAC ID: 7315399755
Enrollment ID: I20240122001177
Provider NameMeliana Amazan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477201127
PECOS PAC ID: 9436592276
Enrollment ID: I20240208000857
Provider NameNina B Williams
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1417735325
PECOS PAC ID: 8820435431
Enrollment ID: I20240319000913
Provider NameEmili Lim
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1164993382
PECOS PAC ID: 6709237985
Enrollment ID: I20240321002454
Provider NameMary Lippencott
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1407393325
PECOS PAC ID: 7517318736
Enrollment ID: I20240321004122
Provider NameJana Brown
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1235200080
PECOS PAC ID: 3476903030
Enrollment ID: I20240326002259
Provider NameJessica Bright
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1548778426
PECOS PAC ID: 3577914787
Enrollment ID: I20240326003441
Provider NameBrenda K Greer-jennings
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1508426727
PECOS PAC ID: 1254771843
Enrollment ID: I20240430001636
Provider NameRobert C Witt
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1326041815
PECOS PAC ID: 4688973373
Enrollment ID: I20240515000824
Provider NameJamie Doan
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1992478820
PECOS PAC ID: 3577006964
Enrollment ID: I20240613001563
Provider NameKristina P Nguyen
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1851080949
PECOS PAC ID: 4981147659
Enrollment ID: I20240621003824
Provider NameDean Salomon Garza
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568079473
PECOS PAC ID: 7911313770
Enrollment ID: I20240625002045
Provider NameCandy Cole
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1215407416
PECOS PAC ID: 3476089145
Enrollment ID: I20241205002034

Reviews and Comments

Clinic/Center in Longview, TX


Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1010 Tristan Ln, Longview, TX 75604
Phone: 903-918-6574    Fax: 903-704-0980
Heather R. Mcconnell, M.a., Pllc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 911 W Loop 281, Suite 423, Longview, TX 75604
Phone: 903-759-2402    Fax: 903-759-2570
Jonathan C. Lockhart, Md
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 911 W Loop 281, Suite 111, Longview, TX 75604
Phone: 903-295-8994    Fax: 903-295-8987
Core Health Systems
Mental Health Clinic
Medicare: Medicare Enrolled
Practice Location: 1300 N 6th St # A, Longview, TX 75601
Phone: 903-232-8928    Fax: 903-918-1813
Willem H. Fahrenbruck, Lpc, Pllc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 3122 Nealy Way Ste 201, Longview, TX 75605
Phone: 903-452-8040    
Diversified Psychological Services
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1508 W Fairmont St, Suite C, Longview, TX 75604
Phone: 903-238-9553    Fax: 903-291-8709
7872 Inc.
Mental Health Clinic
Medicare: Medicare Enrolled
Practice Location: 615 Clinic Dr, Longview, TX 75605
Phone: 903-212-3105    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.