Freedom Behavioral Health - Killeen Pllc | |
809 S W S Young Dr Killeen TX 76543-4801 | |
(254) 226-3090 | |
(888) 595-2540 |
Full Name | Freedom Behavioral Health - Killeen Pllc |
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Speciality | Psychiatry & Neurology |
Location | 809 S W S Young Dr, Killeen, Texas |
Authorized Official Name and Position | Kerry Clemetson (DIRECTOR OF BILLING) |
Authorized Official Contact | 9134059458 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Freedom Behavioral Health - Killeen Pllc 809 S W S Young Dr Killeen TX 76543-4801 Ph: (254) 226-3090 | Freedom Behavioral Health - Killeen Pllc 809 S W S Young Dr Killeen TX 76543-4801 Ph: (254) 226-3090 |
NPI Number | 1679309561 |
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Provider Enumeration Date | 09/09/2024 |
Last Update Date | 09/26/2024 |
Certification Date | 09/26/2024 |
Medicare PECOS PAC ID | 3173050440 |
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Medicare Enrollment ID | O20241227000400 |
Identifier | Type | State | Issuer |
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1679309561 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Krystal Speier |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1891071684 PECOS PAC ID: 0345689063 Enrollment ID: I20240424003834 |
Provider Name | David Wichman |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1760695290 PECOS PAC ID: 2062585805 Enrollment ID: I20240424003909 |
Provider Name | Shanna Samon Losoya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811578875 PECOS PAC ID: 0840728333 Enrollment ID: I20250113000078 |
Provider Name | Tabitha Abelia Workman |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1487397758 PECOS PAC ID: 1658800164 Enrollment ID: I20250129001560 |
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