Active NPI
Fortitude Psychotherapy
- Counselor
- San Antonio, TX
National Provider Identifier
1053600155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 60992
- Legal business name
- FORTITUDE PSYCHOTHERAPY
- Practice address
- 3903 Wiseman Blvd
Ste #211
San Antonio, TX 78251-4401 - Phone
- (210) 381-6593
- NPI assigned
- Mar 30, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Gambuti, LPC, NCC
- Title
- Manager
- Phone
- (210) 381-6593
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 60992 | TX | Primary |
Addresses
Primary practice location
3903 Wiseman Blvd
Ste #211
San Antonio, TX 78251-4401
Mailing address
6130 Briscoe Leaf
San Antonio, TX 78253-5524
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1301443200000",
"number": "1053600155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6130 BRISCOE LEAF",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782535524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3903 WISEMAN BLVD",
"address_2": "STE #211",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782514401",
"telephone_number": "210-381-6593"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORTITUDE PSYCHOTHERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-30",
"last_updated": "2011-03-30",
"status": "A",
"authorized_official_last_name": "GAMBUTI",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "210-381-6593",
"authorized_official_credential": "LPC, NCC"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "TX",
"license": "60992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.