Active NPI
Kaytha Grace Bragg, LPC ASSOCIATE, LCDC
- Professional Counselor
- Boerne, TX
National Provider Identifier
1013744127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 94115
- Practice address
- 31320 Interstate 10 W Ste B
Boerne, TX 78006-5028 - Phone
- (210) 396-7609
- NPI assigned
- Sep 14, 2024
- Last updated
- Sep 14, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 94115 | TX | Primary |
Addresses
Primary practice location
31320 Interstate 10 W Ste B
Boerne, TX 78006-5028
Mailing address
31320 Interstate 10 W Ste B
Boerne, TX 78006-5028
Phone (210) 396-7609
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 |
|---|---|---|---|
| 94115 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726272000000",
"number": "1013744127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31320 INTERSTATE 10 W STE B",
"city": "BOERNE",
"state": "TX",
"postal_code": "780065028",
"telephone_number": "210-396-7609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31320 INTERSTATE 10 W STE B",
"city": "BOERNE",
"state": "TX",
"postal_code": "780065028",
"telephone_number": "210-396-7609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGG",
"first_name": "KAYTHA",
"middle_name": "GRACE",
"name_prefix": "Miss",
"credential": "LPC ASSOCIATE, LCDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-14",
"last_updated": "2024-09-14",
"certification_date": "2024-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "94115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.