| Phoenix Rising Wellness Center Of Corpus Christi, Pllc | |
|
6000 S Staples St Ste 406 Corpus Christi TX 78413-2952 | |
| (361) 739-1679 | |
| (361) 239-4286 |
| Full Name | Phoenix Rising Wellness Center Of Corpus Christi, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 6000 S Staples St Ste 406, Corpus Christi, Texas |
| Authorized Official Name and Position | James P Ikonomopoulos (OWNER) |
| Authorized Official Contact | 3614254684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rising Wellness Center Of Corpus Christi, Pllc Po Box 181459 Corpus Christi TX 78480-1459 Ph: (361) 739-1679 | Phoenix Rising Wellness Center Of Corpus Christi, Pllc 6000 S Staples St Ste 406 Corpus Christi TX 78413-2952 Ph: (361) 739-1679 |
| NPI Number | 1659950343 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Medicare PECOS PAC ID | 0547618845 |
|---|---|
| Medicare Enrollment ID | O20231128000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659950343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | James Peter Ikonomopoulos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477892081 PECOS PAC ID: 2365890662 Enrollment ID: I20231128000305 |
| Provider Name | Claudia Schmidt Ikonomopoulos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699199828 PECOS PAC ID: 9234587122 Enrollment ID: I20231204001178 |
| Provider Name | Jaylen Avery Bowman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154029593 PECOS PAC ID: 7618325457 Enrollment ID: I20231204003724 |
Corpus Christi Class Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4230 S. Padre Island Dr., Suite B, Corpus Christi, TX 78411 Phone: 361-855-1886 | |
Coastal Bend Neurology Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5920 Saratoga Blvd, Suite 500, Corpus Christi, TX 78414 Phone: 361-994-8883 | |
Carroll Ann Williams Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5151 Flynn Pkwy Ste 412f, Corpus Christi, TX 78411 Phone: 361-290-9330 | |
Circles Of Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5333 Everhart Rd Ste 150b, Corpus Christi, TX 78411 Phone: 361-852-3812 Fax: 361-852-6124 | |
Coastal Bend Psychiatric Associates P.a. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6625 Wooldridge Rd, Ste 201, Corpus Christi, TX 78414 Phone: 361-993-8358 Fax: 361-993-8874 | |
Macy Kinzel, Ph.d., P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3434 S Alameda St, Corpus Christi, TX 78411 Phone: 361-855-2710 Fax: 361-855-4204 | |
Aaverlee Clinical Associates Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4455 S Padre Island Dr, Suite 101, Corpus Christi, TX 78411 Phone: 361-814-2273 Fax: 361-814-2274 |