| Jamie L Diaz, LPCS | |
|
8090 Precinct Line Rd Ste 103, Colleyville, TX 76034-7677 | |
| (817) 200-4628 | |
| Not Available |
| Full Name | Jamie L Diaz |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 8090 Precinct Line Rd Ste 103, Colleyville, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831418532 | NPI | - | NPPES |
| 214760501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 64229 (Texas) | Primary |
| Entity Name | Deep Eddy Psychotherapy Management, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457740862 PECOS PAC ID: 2264886936 Enrollment ID: O20230928002745 |
| Mailing Address | Practice Location Address |
|---|---|
| Jamie L Diaz, LPCS 5473 Blair Rd, Ste 100 #242612, Dallas, TX 75231-4227 Ph: (817) 200-4628 | Jamie L Diaz, LPCS 8090 Precinct Line Rd Ste 103, Colleyville, TX 76034-7677 Ph: (817) 200-4628 |
Samantha White, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5004 Thompson Ter Ste 101, Colleyville, TX 76034 Phone: 817-966-8111 | |
Megan Pleshek, LCSW-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 710 Centerpark Dr Ste 100, Colleyville, TX 76034 Phone: 469-496-1693 | |
Arras Darius Khaledi, Counselor Medicare: Medicare Enrolled Practice Location: 404 Forest Meadow Dr, Colleyville, TX 76034 Phone: 919-816-7801 | |
Zachary Peter Lowrie, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 609 Cheek Sparger Rd Ste 112, Colleyville, TX 76034 Phone: 214-666-0452 | |
Mary Gaye Banas, LPC-INTERN Counselor Medicare: Not Enrolled in Medicare Practice Location: 8090 Precinct Line Rd Ste 103, Colleyville, TX 76034 Phone: 469-667-4096 | |
Mrs. Annella Grace Didier, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 6226 A Colleyville Blvd, Colleyville, TX 76034 Phone: 817-797-4948 Fax: 817-545-1565 | |
Robin M Waggoner, MA, LCDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5005 Colleyville Blvd Ste 201, Colleyville, TX 76034 Phone: 817-851-6589 |