Individual provider Active NPI

Mayra Cano, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1063882348
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
68982 Issued in TX
Practice address
12207 Jacobs Pond
San Antonio, TX 78253-5503
Phone
(956) 566-7814
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 68982 TX Primary

Addresses

Primary practice location

12207 Jacobs Pond
San Antonio, TX 78253-5503

Mailing address

4201 Medical Dr Ste 330
San Antonio, TX 78229-5805
Phone (210) 614-4990

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
I20240501002799 TX Practitioner - Mental Health Counselor 3678965787 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Life Counseling of San Antonio LLC Professional CurrentSince Nov 18, 2021 Accepting new patients

Locations

7418 John Smith Dr
Ste 1105
San Antonio, TX 78229
Phone (210) 369-9550

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1063882348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 MEDICAL DR STE 330",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295805",
            "telephone_number": "210-614-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12207 JACOBS POND",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535503",
            "telephone_number": "956-566-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANO",
        "first_name": "MAYRA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "68982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.