| Compassionate Psychiatric Services Of Southlake Pa | |
|
281 W Southlake Blvd Southlake TX 76092-7052 | |
| (469) 200-4093 | |
| (469) 200-4079 |
| Full Name | Compassionate Psychiatric Services Of Southlake Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 281 W Southlake Blvd, Southlake, Texas |
| Authorized Official Name and Position | Nazimuddin Mohammed (CEO) |
| Authorized Official Contact | 2177503053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Psychiatric Services Of Southlake Pa 281 W Southlake Blvd Southlake TX 76092-7052 Ph: (469) 200-4093 | Compassionate Psychiatric Services Of Southlake Pa 281 W Southlake Blvd Southlake TX 76092-7052 Ph: (469) 200-4093 |
| NPI Number | 1295561801 |
|---|---|
| Provider Enumeration Date | 09/10/2024 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/18/2024 |
| Medicare PECOS PAC ID | 0749716942 |
|---|---|
| Medicare Enrollment ID | O20241211003032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295561801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Kathy Mucha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104193861 PECOS PAC ID: 9335315589 Enrollment ID: I20120110000507 |
| Provider Name | Robert J Harden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942225289 PECOS PAC ID: 0840398483 Enrollment ID: I20131107000321 |
| Provider Name | Elias A Alharari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588104541 PECOS PAC ID: 5799058582 Enrollment ID: I20170829004376 |
| Provider Name | Vivian Sona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902358377 PECOS PAC ID: 6204100175 Enrollment ID: I20170918000228 |
| Provider Name | Nazimuddin T Mohammed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316974249 PECOS PAC ID: 4284684663 Enrollment ID: I20180220001277 |
| Provider Name | Jamie L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952962664 PECOS PAC ID: 1850777277 Enrollment ID: I20221007000851 |
| Provider Name | Aaron James Dupre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922706621 PECOS PAC ID: 9032583893 Enrollment ID: I20230316002612 |
| Provider Name | Megan Elizabeth Kelsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881374023 PECOS PAC ID: 1658733258 Enrollment ID: I20230814003570 |
| Provider Name | Sarah Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538840897 PECOS PAC ID: 2466814975 Enrollment ID: I20230816000530 |
| Provider Name | Ericka Lebron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992493639 PECOS PAC ID: 0840654067 Enrollment ID: I20230906003773 |
| Provider Name | Mary Margaret Mcashan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538436886 PECOS PAC ID: 8325402480 Enrollment ID: I20230908000591 |
| Provider Name | Ali Rahman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891381869 PECOS PAC ID: 3476966656 Enrollment ID: I20231130000204 |
| Provider Name | Dora Boyne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174293377 PECOS PAC ID: 1759789803 Enrollment ID: I20231201002030 |
| Provider Name | Keisha M Gill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568812030 PECOS PAC ID: 3678922317 Enrollment ID: I20231207000188 |
| Provider Name | Muta Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043991409 PECOS PAC ID: 7517316045 Enrollment ID: I20231210000026 |
| Provider Name | Olufunke Oludipe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134902075 PECOS PAC ID: 2769826700 Enrollment ID: I20240219001498 |
| Provider Name | Kelli Cook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679831127 PECOS PAC ID: 8628419165 Enrollment ID: I20240514004275 |
| Provider Name | Stacy Bortey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619716321 PECOS PAC ID: 8921541806 Enrollment ID: I20240620000195 |
| Provider Name | Tracy L Hamilton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477273175 PECOS PAC ID: 6901345768 Enrollment ID: I20240826001833 |
| Provider Name | Amy Kristen Murphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316770498 PECOS PAC ID: 6800337759 Enrollment ID: I20240919001758 |
| Provider Name | Marcos Villareal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083876999 PECOS PAC ID: 1052842275 Enrollment ID: I20240930000592 |
| Provider Name | Christine Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790120053 PECOS PAC ID: 9830454982 Enrollment ID: I20241106004025 |
| Provider Name | Amber Fluker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285232520 PECOS PAC ID: 8123553435 Enrollment ID: I20241122004115 |
| Provider Name | Laura Limon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275345159 PECOS PAC ID: 6103356472 Enrollment ID: I20250217000938 |
| Provider Name | Rachel Rebecca Fountain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942015961 PECOS PAC ID: 3678093739 Enrollment ID: I20250220001071 |
Pine Cone Therapies Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2104 Greenbriar Dr, Southlake, TX 76092 Phone: 817-442-9022 | |
Mindforge Psychiatry, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 E Highway 114, Suite 160, Southlake, TX 76092 Phone: 951-796-5464 | |
Dabal Marital Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Miron Dr, Southlake, TX 76092 Phone: 817-876-9958 | |
Pf Dover Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 W Southlake Blvd, Suite Number 172, Southlake, TX 76092 Phone: 309-363-2544 | |
Know Your Worth Counseling And Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1560 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-668-0513 Fax: 817-662-7820 | |
Heritage Behavioral Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2485 E Southlake Blvd, Suite 180, Southlake, TX 76092 Phone: 817-488-9697 Fax: 817-488-9656 | |
Dana Lewin Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 N Carroll Ave Ste 140, Southlake, TX 76092 Phone: 817-797-7968 |