| Stone Creek Psychotherapy | |
|
20915 Kingsland Blvd Katy TX 77450-5548 | |
| (281) 579-0703 | |
| (281) 398-9719 |
| Full Name | Stone Creek Psychotherapy |
|---|---|
| Speciality | Counselor |
| Location | 20915 Kingsland Blvd, Katy, Texas |
| Authorized Official Name and Position | Dianne Wilson Appolito (DIRECTOR/OWNER) |
| Authorized Official Contact | 2815790703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Creek Psychotherapy 20915 Kingsland Blvd Katy TX 77450-5548 Ph: (281) 579-0703 | Stone Creek Psychotherapy 20915 Kingsland Blvd Katy TX 77450-5548 Ph: (281) 579-0703 |
| NPI Number | 1003009978 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 08/03/2021 |
| Certification Date | 08/03/2021 |
| Medicare PECOS PAC ID | 7012313414 |
|---|---|
| Medicare Enrollment ID | O20210910000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003009978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 06714 (Texas) | Primary |
| Provider Name | Diane C Schaefer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770993024 PECOS PAC ID: 4082643689 Enrollment ID: I20160920002567 |
| Provider Name | Leticia H White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770936098 PECOS PAC ID: 1557767969 Enrollment ID: I20210910000993 |
| Provider Name | Stella L Lessert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801207709 PECOS PAC ID: 9638576432 Enrollment ID: I20210921002990 |
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