| Ellie Mental Health (pflugerville) | |
|
701 Fm 685 Ste 450 Pflugerville TX 78660-2899 | |
| (512) 379-7728 | |
| Not Available |
| Full Name | Ellie Mental Health (pflugerville) |
|---|---|
| Speciality | Social Worker |
| Location | 701 Fm 685 Ste 450, Pflugerville, Texas |
| Authorized Official Name and Position | Fabeain Damonte Barkwell (OWNER) |
| Authorized Official Contact | 5128799839 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health (pflugerville) 701 Fm 685 Ste 450 Pflugerville TX 78660-2899 Ph: (512) 379-7728 | Ellie Mental Health (pflugerville) 701 Fm 685 Ste 450 Pflugerville TX 78660-2899 Ph: (512) 379-7728 |
| NPI Number | 1477288728 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 07/21/2022 |
| Certification Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2264803915 |
|---|---|
| Medicare Enrollment ID | O20230117002932 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477288728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amanda R Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598945396 PECOS PAC ID: 8527142637 Enrollment ID: I20080228000264 |
| Provider Name | Fabeain Damonte Barkwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568195220 PECOS PAC ID: 5991176646 Enrollment ID: I20230117002965 |
| Provider Name | Kara D. Ludeker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811469265 PECOS PAC ID: 9335510080 Enrollment ID: I20230117003015 |
| Provider Name | Robert Gallegos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366816803 PECOS PAC ID: 2264884832 Enrollment ID: I20240118004011 |
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