| Center For Emotional Wellness, Pc | |
|
1602 W Business 380 Ste 100 Decatur TX 76234-3267 | |
| (940) 539-0683 | |
| Not Available |
| Full Name | Center For Emotional Wellness, Pc |
|---|---|
| Speciality | Counselor |
| Location | 1602 W Business 380 Ste 100, Decatur, Texas |
| Authorized Official Name and Position | Kelly Suzanne Jones (PRESIDENT) |
| Authorized Official Contact | 9406263923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Emotional Wellness, Pc 1602 W Business 380 Ste 100 Decatur TX 76234-3267 Ph: (940) 539-0683 | Center For Emotional Wellness, Pc 1602 W Business 380 Ste 100 Decatur TX 76234-3267 Ph: (940) 539-0683 |
| NPI Number | 1730953449 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Medicare PECOS PAC ID | 1153773155 |
|---|---|
| Medicare Enrollment ID | O20240116000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730953449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelly Suzanne Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700366051 PECOS PAC ID: 8527307982 Enrollment ID: I20190228002530 |
| Provider Name | Gregory Cecil Gibbons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831788611 PECOS PAC ID: 6800200957 Enrollment ID: I20210201000767 |
| Provider Name | Renee Anne Romine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861014839 PECOS PAC ID: 8729484936 Enrollment ID: I20210913002584 |
| Provider Name | Adriana I Hampton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912157736 PECOS PAC ID: 9537512348 Enrollment ID: I20240129001975 |
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