| Tri-county Clinical | |
|
130 Hays St Luling TX 78648 | |
| (512) 324-2000 | |
| Not Available |
| Full Name | Tri-county Clinical |
|---|---|
| Speciality | Family Medicine |
| Location | 130 Hays St, Luling, Texas |
| Authorized Official Name and Position | Clayton Carnser (VP/COO) |
| Authorized Official Contact | 5123245846 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-county Clinical 1345 Philomena St Suite 410.3 Austin TX 78723 Ph: (512) 324-8960 | Tri-county Clinical 130 Hays St Luling TX 78648 Ph: (512) 324-2000 |
| NPI Number | 1336456227 |
|---|---|
| Provider Enumeration Date | 09/13/2010 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 1153502869 |
|---|---|
| Medicare Enrollment ID | O20110228000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336456227 | NPI | - | NPPES |
| 280565701 | Medicaid | TX | |
| 280565706 | Medicaid | TX | |
| 280565702 | Medicaid | TX |
| Provider Name | Neal M Spears |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053352294 PECOS PAC ID: 2264338037 Enrollment ID: I20031211000449 |
| Provider Name | Jason D Zagrodzky |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1912982018 PECOS PAC ID: 3072509140 Enrollment ID: I20040423000159 |
| Provider Name | Javier E Sanchez |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1518942226 PECOS PAC ID: 9234125311 Enrollment ID: I20040423000261 |
| Provider Name | Robert M Mingea |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093798944 PECOS PAC ID: 7214963552 Enrollment ID: I20050708000768 |
| Provider Name | Osvaldo Gigliotti |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1639123789 PECOS PAC ID: 1658354568 Enrollment ID: I20060817000567 |
| Provider Name | Raju Z Kurunthottical |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184602393 PECOS PAC ID: 3870698152 Enrollment ID: I20070416000054 |
| Provider Name | Roger L Mcroberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053396564 PECOS PAC ID: 9537144373 Enrollment ID: I20070801000272 |
| Provider Name | Jennifer L Ayres |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659495653 PECOS PAC ID: 8729178850 Enrollment ID: I20071213000236 |
| Provider Name | Patricia S Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922292036 PECOS PAC ID: 3870675762 Enrollment ID: I20080131000140 |
| Provider Name | Allison Behr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205005774 PECOS PAC ID: 0143399410 Enrollment ID: I20080513000634 |
| Provider Name | Michael F Lenis |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1295730828 PECOS PAC ID: 8729007646 Enrollment ID: I20080607000008 |
| Provider Name | Jennifer Goss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710180906 PECOS PAC ID: 0143394023 Enrollment ID: I20080811000749 |
| Provider Name | Ryan L Kjome |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245486323 PECOS PAC ID: 0547326654 Enrollment ID: I20090225000359 |
| Provider Name | Jane Ripperger Suhler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962463612 PECOS PAC ID: 1254481161 Enrollment ID: I20090616000312 |
| Provider Name | Virginia Garay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184805467 PECOS PAC ID: 5092866442 Enrollment ID: I20090625000454 |
| Provider Name | Erica C Garcia-pittman |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1194929489 PECOS PAC ID: 5092866814 Enrollment ID: I20090707000496 |
| Provider Name | David Frederick Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114055605 PECOS PAC ID: 2062568645 Enrollment ID: I20090923000464 |
| Provider Name | Nitin Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841266772 PECOS PAC ID: 5092788745 Enrollment ID: I20091120000434 |
| Provider Name | Jessica M Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811942329 PECOS PAC ID: 8022116987 Enrollment ID: I20100326000830 |
| Provider Name | Renda J Holladay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235321696 PECOS PAC ID: 4486782893 Enrollment ID: I20100505000732 |
| Provider Name | Smitha Murthy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063602209 PECOS PAC ID: 2062556350 Enrollment ID: I20100514000097 |
| Provider Name | Lloyd S Berg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548295785 PECOS PAC ID: 0345138756 Enrollment ID: I20101019001432 |
| Provider Name | Caron Ea Farrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164621348 PECOS PAC ID: 1456548494 Enrollment ID: I20101203000165 |
| Provider Name | David Michael Clampitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043430325 PECOS PAC ID: 7517154552 Enrollment ID: I20101203000192 |
| Provider Name | Anita Sharan Jesudass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538239843 PECOS PAC ID: 0446437446 Enrollment ID: I20110531000205 |
| Provider Name | Amanda Whiteley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750421756 PECOS PAC ID: 9133270044 Enrollment ID: I20110721000685 |
| Provider Name | Lauren N Garapedian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942248315 PECOS PAC ID: 9436119112 Enrollment ID: I20110830000223 |
| Provider Name | Polawyn C Mckinney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982895173 PECOS PAC ID: 0143490193 Enrollment ID: I20110830000287 |
| Provider Name | Emily S Greenspahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700108818 PECOS PAC ID: 4981875309 Enrollment ID: I20110915000383 |
| Provider Name | Rosario C Deleon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164622809 PECOS PAC ID: 4880865989 Enrollment ID: I20110921000740 |
| Provider Name | Samuel Collier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508064114 PECOS PAC ID: 9830229202 Enrollment ID: I20110926000410 |
| Provider Name | Tara T Wagner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144422098 PECOS PAC ID: 5698935542 Enrollment ID: I20120329000786 |
| Provider Name | Puja Patel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225313851 PECOS PAC ID: 1951562487 Enrollment ID: I20120410000677 |
| Provider Name | April K Watkins |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1659689941 PECOS PAC ID: 4688835820 Enrollment ID: I20120413000585 |
| Provider Name | Lynn Monnat |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821252685 PECOS PAC ID: 3577725316 Enrollment ID: I20120424000463 |
| Provider Name | Gabriel R Garza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780864835 PECOS PAC ID: 1254587207 Enrollment ID: I20120808000164 |
| Provider Name | Blair Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649404401 PECOS PAC ID: 8820244247 Enrollment ID: I20120816000927 |
| Provider Name | Jamie V Zachrison |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649431818 PECOS PAC ID: 9234387978 Enrollment ID: I20120921000103 |
| Provider Name | Diana Ann Yens |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255394375 PECOS PAC ID: 9436050978 Enrollment ID: I20120926000663 |
| Provider Name | Allan E Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578678298 PECOS PAC ID: 7618127804 Enrollment ID: I20121024000586 |
| Provider Name | Melissa Gail-inga Eshelman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629069299 PECOS PAC ID: 7618934613 Enrollment ID: I20130128000369 |
| Provider Name | Janie Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407108814 PECOS PAC ID: 6204079304 Enrollment ID: I20130821000125 |
| Provider Name | Jamilla C Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932337029 PECOS PAC ID: 1052568102 Enrollment ID: I20131108001448 |
| Provider Name | Tannon D Carroll |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1154484715 PECOS PAC ID: 2365613502 Enrollment ID: I20131217000386 |
| Provider Name | Valerie C Rosen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407883580 PECOS PAC ID: 4385871474 Enrollment ID: I20131217000908 |
| Provider Name | David R Heckler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003242710 PECOS PAC ID: 9234369174 Enrollment ID: I20140220001217 |
| Provider Name | Sussann Kotara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588899041 PECOS PAC ID: 1658594189 Enrollment ID: I20140602000369 |
| Provider Name | Kristin V Valderas-escamilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811121668 PECOS PAC ID: 9032332580 Enrollment ID: I20140602001113 |
| Provider Name | Gayle Ayers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508182668 PECOS PAC ID: 6608099015 Enrollment ID: I20140603000585 |
| Provider Name | Amanda S Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922235753 PECOS PAC ID: 6608035761 Enrollment ID: I20140614000095 |
| Provider Name | Christine A. Laguna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982769170 PECOS PAC ID: 1355665712 Enrollment ID: I20150114000433 |
| Provider Name | Chad Hooten |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003100249 PECOS PAC ID: 3971829060 Enrollment ID: I20150309001147 |
| Provider Name | Julie Farrington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427114545 PECOS PAC ID: 4789623588 Enrollment ID: I20150724010839 |
| Provider Name | Jennifer Ward |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922311539 PECOS PAC ID: 4082922653 Enrollment ID: I20150930002702 |
| Provider Name | Richard G Key |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750438644 PECOS PAC ID: 0547438384 Enrollment ID: I20151001000313 |
| Provider Name | Joseph L Kugler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093026734 PECOS PAC ID: 7012218084 Enrollment ID: I20151216000971 |
| Provider Name | Sasha Jaquez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558677575 PECOS PAC ID: 7214225499 Enrollment ID: I20161004002875 |
| Provider Name | Umesh C Bhandari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548572274 PECOS PAC ID: 4183944648 Enrollment ID: I20170620002198 |
| Provider Name | Delaney P Herman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184145468 PECOS PAC ID: 2466725254 Enrollment ID: I20170830000123 |
| Provider Name | Diane Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306073606 PECOS PAC ID: 5597038026 Enrollment ID: I20170906000601 |
| Provider Name | Alexandra Lamari-fisher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174065247 PECOS PAC ID: 9032484811 Enrollment ID: I20171004001269 |
| Provider Name | Meredith Brinster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821591231 PECOS PAC ID: 1355692740 Enrollment ID: I20180925000321 |
| Provider Name | Aysha Sabri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649618133 PECOS PAC ID: 8921399049 Enrollment ID: I20180925000590 |
| Provider Name | Mohammad J Javed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497195481 PECOS PAC ID: 2769792746 Enrollment ID: I20180925001177 |
| Provider Name | Ryan Landis Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750760948 PECOS PAC ID: 6103131495 Enrollment ID: I20190117002183 |
| Provider Name | Alysse Craft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447726377 PECOS PAC ID: 8325386048 Enrollment ID: I20190205001246 |
| Provider Name | Roshni Koli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164612198 PECOS PAC ID: 1355510918 Enrollment ID: I20190212002436 |
| Provider Name | Kari Whatley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033505979 PECOS PAC ID: 3375853856 Enrollment ID: I20190404001661 |
| Provider Name | D. Jeffrey Newport |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275646291 PECOS PAC ID: 6406913268 Enrollment ID: I20190410002644 |
| Provider Name | Jeffrey Shahidullah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336612266 PECOS PAC ID: 4587906953 Enrollment ID: I20190506000057 |
| Provider Name | Beth K Boyarsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487731758 PECOS PAC ID: 6305936352 Enrollment ID: I20190514000669 |
| Provider Name | Carol Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083699870 PECOS PAC ID: 2163454125 Enrollment ID: I20190716003714 |
| Provider Name | Nicholas F Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164878914 PECOS PAC ID: 8628305612 Enrollment ID: I20190814001400 |
| Provider Name | Kelly A Campbell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205240611 PECOS PAC ID: 9739478595 Enrollment ID: I20190828002958 |
| Provider Name | Diana Prieto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720424567 PECOS PAC ID: 2062785405 Enrollment ID: I20191009001244 |
| Provider Name | Eric Shute |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023350832 PECOS PAC ID: 4082945787 Enrollment ID: I20191010002112 |
| Provider Name | Mariel Cannady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063921708 PECOS PAC ID: 2466783881 Enrollment ID: I20191015003194 |
| Provider Name | Ashley R Trust |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497165948 PECOS PAC ID: 6103113915 Enrollment ID: I20191211001984 |
| Provider Name | Dajonitta L Richmond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265896195 PECOS PAC ID: 1052745106 Enrollment ID: I20191223001484 |
| Provider Name | Benjamin Chambers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255725511 PECOS PAC ID: 1456642537 Enrollment ID: I20191223002040 |
| Provider Name | Celeste Erika Valencia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013273317 PECOS PAC ID: 8325333826 Enrollment ID: I20191227000664 |
| Provider Name | Amanda Jean Simonton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134606833 PECOS PAC ID: 0749615912 Enrollment ID: I20200116000038 |
| Provider Name | Sean P Kerrigan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023282001 PECOS PAC ID: 6002058567 Enrollment ID: I20200430001234 |
| Provider Name | William David Rumbaugh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285076554 PECOS PAC ID: 2860622859 Enrollment ID: I20200521002724 |
| Provider Name | Sara Gill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124571088 PECOS PAC ID: 1456772359 Enrollment ID: I20200602000106 |
| Provider Name | Claire R Selinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689932394 PECOS PAC ID: 7810275781 Enrollment ID: I20200610001920 |
| Provider Name | Delana Parker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710250014 PECOS PAC ID: 5193147569 Enrollment ID: I20200612002281 |
| Provider Name | Nithya Mani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871912725 PECOS PAC ID: 2062830839 Enrollment ID: I20200910000687 |
| Provider Name | Ankita Krishnan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861010126 PECOS PAC ID: 0547671844 Enrollment ID: I20201117002018 |
| Provider Name | Oscar Widales Benitez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710479589 PECOS PAC ID: 9335550565 Enrollment ID: I20201119001927 |
| Provider Name | Melissa Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497186944 PECOS PAC ID: 6305257320 Enrollment ID: I20201124000912 |
| Provider Name | Laura Blakley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346728854 PECOS PAC ID: 2567873599 Enrollment ID: I20201124001473 |
| Provider Name | Andre N Gardiner-martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124664933 PECOS PAC ID: 9133530173 Enrollment ID: I20201124001780 |
| Provider Name | Ann Orozco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356988919 PECOS PAC ID: 7214348150 Enrollment ID: I20201124002344 |
| Provider Name | Brittany Houston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235784919 PECOS PAC ID: 2365856895 Enrollment ID: I20210125002262 |
| Provider Name | Levi Defilipp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376160127 PECOS PAC ID: 0042624595 Enrollment ID: I20210125002946 |
| Provider Name | Lindsey Ewing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952884223 PECOS PAC ID: 3870907330 Enrollment ID: I20210126000115 |
| Provider Name | Ana El Behadli Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235744418 PECOS PAC ID: 4183038649 Enrollment ID: I20210126000315 |
| Provider Name | Sarah J Schoffstall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952929184 PECOS PAC ID: 9931513348 Enrollment ID: I20210126002695 |
| Provider Name | Adam Ruggle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417367186 PECOS PAC ID: 3870849607 Enrollment ID: I20210510002341 |
| Provider Name | Aubrey Werzner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346654241 PECOS PAC ID: 5294136628 Enrollment ID: I20210623001509 |
| Provider Name | Nikita Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285959163 PECOS PAC ID: 1759695711 Enrollment ID: I20210624001012 |
| Provider Name | Audrey R Cortesi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205449469 PECOS PAC ID: 7113324849 Enrollment ID: I20210923001032 |
| Provider Name | Alba Lara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073047767 PECOS PAC ID: 2961800743 Enrollment ID: I20211008000299 |
| Provider Name | Jeffrey Abass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851897730 PECOS PAC ID: 6901204460 Enrollment ID: I20211013002784 |
| Provider Name | Jacqueline Posada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174918114 PECOS PAC ID: 2769743129 Enrollment ID: I20211101001228 |
| Provider Name | Kathryn Bruce Hanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417582891 PECOS PAC ID: 2668860164 Enrollment ID: I20211103001086 |
| Provider Name | Lisa Boyars |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043659923 PECOS PAC ID: 4082903919 Enrollment ID: I20220215002081 |
| Provider Name | Zakira Duff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598396780 PECOS PAC ID: 1850786807 Enrollment ID: I20220310000145 |
| Provider Name | Annajaidie Salinas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780215970 PECOS PAC ID: 8820483878 Enrollment ID: I20220310000250 |
| Provider Name | Rachel Alhanti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922772557 PECOS PAC ID: 0749675627 Enrollment ID: I20220310001892 |
| Provider Name | Haoyu Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891100459 PECOS PAC ID: 0446539720 Enrollment ID: I20220310002354 |
| Provider Name | Victoria Felkl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376969824 PECOS PAC ID: 8022366178 Enrollment ID: I20220315002561 |
| Provider Name | Melvin Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891223327 PECOS PAC ID: 8123393592 Enrollment ID: I20220318001243 |
| Provider Name | Anna Beavers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841947355 PECOS PAC ID: 4587042833 Enrollment ID: I20220527001799 |
| Provider Name | Andrey Shalomov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750813499 PECOS PAC ID: 2264774173 Enrollment ID: I20220527002227 |
| Provider Name | Irma Valdez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952840027 PECOS PAC ID: 3678951860 Enrollment ID: I20220531001183 |
| Provider Name | Dana M.c. Valdez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255793246 PECOS PAC ID: 4183952641 Enrollment ID: I20220614000408 |
| Provider Name | Tenisha Hunter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497381628 PECOS PAC ID: 8921487224 Enrollment ID: I20220616000950 |
| Provider Name | Beatrice Casaula |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285357731 PECOS PAC ID: 9830569870 Enrollment ID: I20230109000144 |
| Provider Name | Molly Clayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942925730 PECOS PAC ID: 5496126013 Enrollment ID: I20230118002422 |
| Provider Name | Kathleen Stanton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346697885 PECOS PAC ID: 3375914831 Enrollment ID: I20230119001663 |
| Provider Name | Eric J Gonzales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760913479 PECOS PAC ID: 1850763830 Enrollment ID: I20230221002377 |
| Provider Name | Kelsie Piedra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023722360 PECOS PAC ID: 5799140190 Enrollment ID: I20230508000072 |
| Provider Name | Laura Amoscato |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083047880 PECOS PAC ID: 4385872589 Enrollment ID: I20230526001080 |
| Provider Name | Tiffany Sizemore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730888496 PECOS PAC ID: 8921460940 Enrollment ID: I20230808002254 |
| Provider Name | Lisa Mcdermott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851696546 PECOS PAC ID: 9133581176 Enrollment ID: I20230808003400 |
| Provider Name | Emily A Brooke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912605122 PECOS PAC ID: 0648632521 Enrollment ID: I20230809000946 |
| Provider Name | Daniela B Mcfarland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215398169 PECOS PAC ID: 7113389040 Enrollment ID: I20230809002797 |
| Provider Name | Lacey Branker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851666390 PECOS PAC ID: 5890157747 Enrollment ID: I20230809004050 |
| Provider Name | Priya Elizabeth Kumar-kaparaboyna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578943411 PECOS PAC ID: 7810293669 Enrollment ID: I20230911002554 |
| Provider Name | Briana Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902582752 PECOS PAC ID: 2860849445 Enrollment ID: I20231103003525 |
| Provider Name | Gregory Ziomek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356908776 PECOS PAC ID: 7416304407 Enrollment ID: I20231113003475 |
| Provider Name | Christina Verzijl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417639691 PECOS PAC ID: 3274980073 Enrollment ID: I20231116001611 |
| Provider Name | Christopher Powell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891287132 PECOS PAC ID: 8123476314 Enrollment ID: I20231129000150 |
| Provider Name | Angelica Oscos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538840350 PECOS PAC ID: 6406205004 Enrollment ID: I20231207003119 |
| Provider Name | Kate Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407559784 PECOS PAC ID: 6406206242 Enrollment ID: I20231220001506 |
| Provider Name | Meredith D Ehrhardt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659965127 PECOS PAC ID: 6204287311 Enrollment ID: I20240112001252 |
| Provider Name | Sarah Gojer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508534405 PECOS PAC ID: 5799137980 Enrollment ID: I20240124000452 |
| Provider Name | Mariah Stickley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033984414 PECOS PAC ID: 7719321918 Enrollment ID: I20240215002174 |
| Provider Name | Diana Reyes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235855826 PECOS PAC ID: 5193169308 Enrollment ID: I20240215002497 |
| Provider Name | Kevin M Grabski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689022766 PECOS PAC ID: 8123442886 Enrollment ID: I20240219000717 |
| Provider Name | Beverly Bernal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356983159 PECOS PAC ID: 9133519085 Enrollment ID: I20240405003129 |
| Provider Name | Jigar Jayendrabhai Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558895771 PECOS PAC ID: 4082986823 Enrollment ID: I20240503000147 |
| Provider Name | Young Shin Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952368508 PECOS PAC ID: 2264443761 Enrollment ID: I20240606004014 |
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