Individual provider Active NPI

Cynthia Anne Granados, LPC, LMFT

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1033304738
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
61842 Issued in TX
Practice address
1800 NE Loop 410 Ste 209
San Antonio, TX 78217-5210
Phone
(210) 832-0701
Fax
(210) 697-9706
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 200994 TX
Professional Counselor 101YP2500X 61842 TX Primary

Addresses

Primary practice location

1800 NE Loop 410 Ste 209
San Antonio, TX 78217-5210

Mailing address

1800 NE Loop 410 Ste 209
San Antonio, TX 78217-5210
Phone (210) 832-0701

Other identifiers 2

IdentifierTypeStateIssuer
200994OtherTXLMFT
61842OtherTXLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312000735 TX Practitioner - Mental Health Counselor 1850737933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61842TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Mar 1, 2024 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1033304738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NE LOOP 410 STE 209",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175210",
            "telephone_number": "210-832-0701",
            "fax_number": "210-697-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NE LOOP 410 STE 209",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175210",
            "telephone_number": "210-832-0701",
            "fax_number": "210-697-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "CYNTHIA",
        "middle_name": "ANNE",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "200994",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "200994",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "61842",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.