Nickolas Scott Raczek, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

82015 Issued in TX

Practice address

6812 Bandera Rd Ste 102
San Antonio, TX 78238-1378

Phone

(210) 261-3350

Fax

(210) 261-1794

NPI assigned

Dec 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bexar County Board of Trustees for Mental Health Mental Retardation

  • Counselor
  • San Antonio, TX
  • NPI 1730134586
  Medicare reassignment

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1053917377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1060",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 BANDERA RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381378",
            "telephone_number": "210-261-3350",
            "fax_number": "210-261-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACZEK",
        "first_name": "NICKOLAS",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua L Rackham, DMD
• Keith Rackley, CRNA
• Tanya Marie Rackley, M.D.
• Ashley Jordan Rackow
• Toni Wynn Racoma, O.D.
• Margaret Rad, LCDC
• Kevin Rada
• Natasha Rademacher, LPC
• Collin Rader
• Radiance Medspa of Texas PLLC

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.