| The Lakewood Group | |
|
2237 Ridge Rd Ste 101 Rockwall TX 75087-5164 | |
| (972) 771-3969 | |
| (972) 771-8258 |
| Full Name | The Lakewood Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 2237 Ridge Rd, Rockwall, Texas |
| Authorized Official Name and Position | Robert F Mehl (PSYCHOLOGIST) |
| Authorized Official Contact | 9727713969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lakewood Group 2237 Ridge Rd Ste 101 Rockwall TX 75087-5164 Ph: (972) 771-3969 | The Lakewood Group 2237 Ridge Rd Ste 101 Rockwall TX 75087-5164 Ph: (972) 771-3969 |
| NPI Number | 1912999715 |
|---|---|
| Provider Enumeration Date | 08/17/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7618950296 |
|---|---|
| Medicare Enrollment ID | O20040612000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912999715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Texas) | Primary |
| Provider Name | Judy L Rambur |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871522094 PECOS PAC ID: 1951300359 Enrollment ID: I20061213000065 |
| Provider Name | Christine M Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528224680 PECOS PAC ID: 8426126624 Enrollment ID: I20090402000623 |
| Provider Name | Howard M Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275533812 PECOS PAC ID: 6002087954 Enrollment ID: I20110926000298 |
| Provider Name | Robert F Mehl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912947979 PECOS PAC ID: 2769489269 Enrollment ID: I20111122000607 |
| Provider Name | Michael K Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114298122 PECOS PAC ID: 4981837325 Enrollment ID: I20140509000097 |
| Provider Name | Johnathan L Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760822027 PECOS PAC ID: 0648494864 Enrollment ID: I20140610000235 |
| Provider Name | Joni L Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720330624 PECOS PAC ID: 1153541545 Enrollment ID: I20180827000189 |
| Provider Name | Jeffrey M Vance |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235615592 PECOS PAC ID: 2860800133 Enrollment ID: I20210427000114 |
| Provider Name | Jessica L John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205519774 PECOS PAC ID: 7517321144 Enrollment ID: I20230914001440 |
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