Active NPI
Vanessa Nicole Benavides
- Counselor
- Crystal City, TX
National Provider Identifier
1003442385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 79381
- Practice address
- 308 S Cesar Chavez Ave
Crystal City, TX 78839-4200 - Phone
- (830) 374-2301
- NPI assigned
- Mar 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 79381 | TX | Primary |
Addresses
Primary practice location
308 S Cesar Chavez Ave
Crystal City, TX 78839-4200
Mailing address
601 W Webb St
Crystal City, TX 78839-3825
Phone (830) 374-6968
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79381 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1003442385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W WEBB ST",
"city": "CRYSTAL CITY",
"state": "TX",
"postal_code": "788393825",
"telephone_number": "830-374-6968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 S CESAR CHAVEZ AVE",
"city": "CRYSTAL CITY",
"state": "TX",
"postal_code": "788394200",
"telephone_number": "830-374-2301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENAVIDES",
"first_name": "VANESSA",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "79381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crystal City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.