| Dr James P Ikonomopoulos, PHD, LPC-S | |
|
4646 Corona Dr Ste 140, Corpus Christi, TX 78411-4302 | |
| (361) 425-4684 | |
| Not Available |
| Full Name | Dr James P Ikonomopoulos |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 4646 Corona Dr Ste 140, Corpus Christi, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477892081 | NPI | - | NPPES |
| 3123812-02 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 67746 (Texas) | Primary |
| Entity Name | Phoenix Rising Wellness Center Of Corpus Christi, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659950343 PECOS PAC ID: 0547618845 Enrollment ID: O20231128000251 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James P Ikonomopoulos, PHD, LPC-S 2134 Shadi St, Corpus Christi, TX 78418-7013 Ph: (361) 425-4684 | Dr James P Ikonomopoulos, PHD, LPC-S 4646 Corona Dr Ste 140, Corpus Christi, TX 78411-4302 Ph: (361) 425-4684 |
Ms. D. Charlene Hackett, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 7252 Mansions Dr, Corpus Christi, TX 78414 Phone: 360-304-0392 | |
Robert Keith Martin, BA LCDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1801 S Alameda, Ste 150, Corpus Christi, TX 78404 Phone: 361-854-9199 Fax: 361-888-9250 | |
Ashley Kasperski Boyer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2430 Thankful St, Corpus Christi, TX 78418 Phone: 337-523-2389 | |
Mrs. Edra B Saavedra, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Waco St, Corpus Christi, TX 78401 Phone: 361-886-1484 | |
Gabriella Victoria Carrillo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1709 Chisolm Trl, Corpus Christi, TX 78410 Phone: 956-342-3120 | |
Brenda Kay Brown, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3434 S Alameda St, Corpus Christi, TX 78411 Phone: 361-855-2710 Fax: 361-855-4204 | |
Mrs. Raquel Lobaina, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4610 Coody Ln, Corpus Christi, TX 78413 Phone: 305-799-9609 |