| Etsah Counseling Center, Pllc | |
|
3500 Hillcrest Dr Ste 2b Waco TX 76708-3100 | |
| (254) 447-4539 | |
| (254) 237-5369 |
| Full Name | Etsah Counseling Center, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 3500 Hillcrest Dr Ste 2b, Waco, Texas |
| Authorized Official Name and Position | Ntiense Covey (OWNER) |
| Authorized Official Contact | 2542308501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etsah Counseling Center, Pllc 200 W State Highway 6 Ste 217 Waco TX 76712-3975 Ph: (254) 447-4539 | Etsah Counseling Center, Pllc 3500 Hillcrest Dr Ste 2b Waco TX 76708-3100 Ph: (254) 447-4539 |
| NPI Number | 1427591320 |
|---|---|
| Provider Enumeration Date | 11/24/2016 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Medicare PECOS PAC ID | 7719262153 |
|---|---|
| Medicare Enrollment ID | O20170327000439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427591320 | NPI | - | NPPES |
| 410283201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ntiense Covey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538602834 PECOS PAC ID: 7315220175 Enrollment ID: I20170202000412 |
| Provider Name | Amanda Gayle Ibanez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326569666 PECOS PAC ID: 4789950270 Enrollment ID: I20171027002508 |
| Provider Name | Ashley M Pitts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154838357 PECOS PAC ID: 3274893854 Enrollment ID: I20180130000546 |
| Provider Name | Mary Ellen Mchugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376874743 PECOS PAC ID: 9436331998 Enrollment ID: I20220503002492 |
| Provider Name | Jennifer Wilfong |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821606898 PECOS PAC ID: 2961853965 Enrollment ID: I20240103003720 |
| Provider Name | Stacey Odell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659014983 PECOS PAC ID: 4880045160 Enrollment ID: I20240111000901 |
| Provider Name | Susan L Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467178020 PECOS PAC ID: 9436692720 Enrollment ID: I20240614001212 |
| Provider Name | Ashleigh Elmshaeuser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154192730 PECOS PAC ID: 6305373861 Enrollment ID: I20241220003741 |
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