| Darla Lane Pllc | |
|
790 Generations Dr Ste 410 New Braunfels TX 78130-6720 | |
| (830) 625-0599 | |
| (830) 625-5877 |
| Full Name | Darla Lane Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 790 Generations Dr Ste 410, New Braunfels, Texas |
| Authorized Official Name and Position | Darla K Lane (OWNER) |
| Authorized Official Contact | 8306250599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Darla Lane Pllc 790 Generations Dr Ste 410 New Braunfels TX 78130-6720 Ph: (830) 625-0599 | Darla Lane Pllc 790 Generations Dr Ste 410 New Braunfels TX 78130-6720 Ph: (830) 625-0599 |
| NPI Number | 1952390247 |
|---|---|
| Provider Enumeration Date | 10/19/2005 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 8527023365 |
|---|---|
| Medicare Enrollment ID | O20041122000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952390247 | NPI | - | NPPES |
| 174470801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17884 (Texas) | Primary |
| Provider Name | Kelvin D Mccoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043382542 PECOS PAC ID: 6608780465 Enrollment ID: I20031211000231 |
| Provider Name | Darla K Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376532937 PECOS PAC ID: 9133184989 Enrollment ID: I20041123000291 |
| Provider Name | Melanie B Blank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700584398 PECOS PAC ID: 9335514439 Enrollment ID: I20230403001267 |
| Provider Name | Susan M Greco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952017774 PECOS PAC ID: 4284085747 Enrollment ID: I20240109001995 |
| Provider Name | Ivonne Patricia Mouser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205397957 PECOS PAC ID: 0143671644 Enrollment ID: I20240109003730 |
| Provider Name | Shar Mckelvie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124577085 PECOS PAC ID: 8426409830 Enrollment ID: I20240110002916 |
| Provider Name | Randall R Chavez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013162403 PECOS PAC ID: 6507217858 Enrollment ID: I20240110005006 |
| Provider Name | Ulysees T Cantero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164906632 PECOS PAC ID: 1052762317 Enrollment ID: I20240111000114 |
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