Ethel H Gomez, LPC
Individual provider Active NPI Professional Counselor · Del Rio, TX
NPI 1497112841 · NPPES record last updated Nov 16, 2023
Key facts
- NPI
- 1497112841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 71136 (TX)
- Practice address
- 119 E Academy St
Del Rio, TX 78840-6072 - Phone
- (830) 422-3305
- Fax
- (830) 422-3305
- NPI assigned
- Jan 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- United Medical Centers
Practice addresses (Care Compare)
913 S Main St
Del Rio, TX 78840-5807
Phone (830) 774-5534
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240702001880 | TX | Practitioner - Mental Health Counselor | 1052855996 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71136 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Medical Centers | Current |
Accepting new patients | |
| United Medical Centers | Current |
Accepting new patients |
Locations
913 S Main St
Del Rio, TX 78840
Phone (830) 774-5534
119 E Academy St
Del Rio, TX 78840
Phone (830) 422-3305
2525 N Veterans Blvd
Eagle Pass, TX 78852
Phone (830) 773-5358
Interoperability endpoints
- ethel.gomez.p1@direct.umchealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 71136 | TX | Yes |
Addresses
Primary practice location
119 E Academy St
Del Rio, TX 78840-6072
Mailing address
PO Box 1470
Eagle Pass, TX 78853-1470
Phone (830) 773-8917
Other practice location 1
501 W Cantu Rd
Del Rio, TX 78840-3056
Phone (830) 461-4731
Other practice location 2
409 Meandering Way
Del Rio, TX 78840-2523
Phone (830) 734-4171
Other practice location 3
401 W Cantu Rd Ste C
Del Rio, TX 78840-3093
Phone (830) 734-4171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 361226902 | Medicaid | TX | |
| 71136 | Other | TX | TX STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS |
Other names
- Ethel Hernandez
Other providers in Del Rio, TX
- Lori Ann Garza
- Misty Williams Garza
- Elaine Renee Gattenby
- Ge Wiese Dba
- Heather Gibbs
- Lisa Ann Gomez
- Patricia Garcia Gomez
- Romina Mariana Gonzalez Flores
- Mayra Lynn Gonzalez
- Goodnight Sleep Center
All providers in Del Rio, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.