| Psych Dimensions Inc | |
|
101 W Cooperative Way Ste 110 Georgetown TX 78626-8209 | |
| (512) 535-3777 | |
| (512) 765-9153 |
| Full Name | Psych Dimensions Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 101 W Cooperative Way Ste 110, Georgetown, Texas |
| Authorized Official Name and Position | Ronald Moore (PRESIDENT) |
| Authorized Official Contact | 5125353777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych Dimensions Inc 2109 Monticello Ct Round Rock TX 78665-5021 Ph: (512) 535-3777 | Psych Dimensions Inc 101 W Cooperative Way Ste 110 Georgetown TX 78626-8209 Ph: (512) 535-3777 |
| NPI Number | 1538534086 |
|---|---|
| Provider Enumeration Date | 12/09/2015 |
| Last Update Date | 05/12/2020 |
| Medicare PECOS PAC ID | 0143589739 |
|---|---|
| Medicare Enrollment ID | O20180104000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538534086 | NPI | - | NPPES |
| Provider Name | Karley Y Little |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467553198 PECOS PAC ID: 4082612023 Enrollment ID: I20121017000629 |
| Provider Name | Ronald B Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578805123 PECOS PAC ID: 2466670286 Enrollment ID: I20140822000406 |
| Provider Name | Theresa L Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063845345 PECOS PAC ID: 7911125737 Enrollment ID: I20140822001820 |
| Provider Name | Marya J Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427358274 PECOS PAC ID: 4688761208 Enrollment ID: I20161102001237 |
| Provider Name | Jeanne Marie Blakeslee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265907414 PECOS PAC ID: 4587917588 Enrollment ID: I20181022000344 |
| Provider Name | Martha Allee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780295584 PECOS PAC ID: 3779902358 Enrollment ID: I20200930003754 |
| Provider Name | Christopher John Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437739653 PECOS PAC ID: 8325441207 Enrollment ID: I20210729002611 |
| Provider Name | Jesse Levi Maggard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962254813 PECOS PAC ID: 7416397963 Enrollment ID: I20240430004404 |
| Provider Name | Tracy A Van Horn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457651994 PECOS PAC ID: 5597290833 Enrollment ID: I20241125000510 |
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