| Tyler Counseling & Assessment Center | |
|
1121 E Southeast Loop 323 Ste.204 Tyler TX 75701-9660 | |
| (903) 581-0933 | |
| (903) 581-3977 |
| Full Name | Tyler Counseling & Assessment Center |
|---|---|
| Speciality | Psychologist |
| Location | 1121 E Southeast Loop 323, Tyler, Texas |
| Authorized Official Name and Position | Ron L Roberts (PRESIDENT) |
| Authorized Official Contact | 9035810933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Counseling & Assessment Center 1121 E Southeast Loop 323 Ste.204 Tyler TX 75701-9660 Ph: (903) 581-0933 | Tyler Counseling & Assessment Center 1121 E Southeast Loop 323 Ste.204 Tyler TX 75701-9660 Ph: (903) 581-0933 |
| NPI Number | 1659483840 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 0446249460 |
|---|---|
| Medicare Enrollment ID | O20040506000922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659483840 | NPI | - | NPPES |
| 080723201 | Medicaid | TX |
| Provider Name | Erick R Lenert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982716189 PECOS PAC ID: 9032107594 Enrollment ID: I20040504000202 |
| Provider Name | Jana M Sisk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053551341 PECOS PAC ID: 2466502620 Enrollment ID: I20090609000479 |
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