| Third Summit Group, Inc. | |
|
13341 W Hwy 290 Ste 1-105 Austin TX 78737-9160 | |
| (210) 913-7791 | |
| Not Available |
| Full Name | Third Summit Group, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 13341 W Hwy 290 Ste 1-105, Austin, Texas |
| Authorized Official Name and Position | Rosemary Elizalde (PRESIDENT/CEO) |
| Authorized Official Contact | 2109137791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Third Summit Group, Inc. 13341 W Hwy 290 Ste 1-105 Austin TX 78737-9160 Ph: (210) 913-7791 | Third Summit Group, Inc. 13341 W Hwy 290 Ste 1-105 Austin TX 78737-9160 Ph: (210) 913-7791 |
| NPI Number | 1841077245 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 12/15/2023 |
| Certification Date | 10/06/2023 |
| Medicare PECOS PAC ID | 0840642898 |
|---|---|
| Medicare Enrollment ID | O20240116001859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841077245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Haylie Lafleur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457067076 PECOS PAC ID: 0345772687 Enrollment ID: I20241011002124 |
| Provider Name | Taylor Maureen Barstad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184366718 PECOS PAC ID: 6305378647 Enrollment ID: I20241011002379 |
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