The Austin Center For Grief And Loss | |
2413 Greenlawn Pkwy Austin TX 78757-2126 | |
(512) 472-7878 | |
(512) 467-1111 |
Full Name | The Austin Center For Grief And Loss |
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Speciality | Counselor |
Location | 2413 Greenlawn Pkwy, Austin, Texas |
Authorized Official Name and Position | Mary Dickerson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5124727878 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Austin Center For Grief And Loss 2413 Greenlawn Pkwy Austin TX 78757-2126 Ph: (512) 472-7878 | The Austin Center For Grief And Loss 2413 Greenlawn Pkwy Austin TX 78757-2126 Ph: (512) 472-7878 |
NPI Number | 1952738486 |
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Provider Enumeration Date | 09/30/2013 |
Last Update Date | 02/05/2018 |
Medicare PECOS PAC ID | 2163783812 |
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Medicare Enrollment ID | O20180221001477 |
Identifier | Type | State | Issuer |
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1952738486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Elaine Dunn |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588030142 PECOS PAC ID: 5294037420 Enrollment ID: I20160105002791 |
Provider Name | Nadia Katrina Velasquez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376104828 PECOS PAC ID: 9537498464 Enrollment ID: I20190903000285 |
Provider Name | Laura Gomez-horton |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1760561567 PECOS PAC ID: 4587048939 Enrollment ID: I20220902000287 |
Provider Name | Jessica Marquez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861192742 PECOS PAC ID: 6103290705 Enrollment ID: I20230322001723 |
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