Individual provider Active NPI

Susan R Smart, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1063920551
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75500 Issued in TX
Practice address
10807 Pern Betl Rd Ste 300
San Antonio, TX 78217-3144
Phone
(210) 245-7862
Fax
(210) 245-7951
NPI assigned
Jan 18, 2018
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 75500 TX Primary

Addresses

Primary practice location

10807 Pern Betl Rd Ste 300
San Antonio, TX 78217-3144

Mailing address

10807 Pern Betl Rd Ste 300
San Antonio, TX 78217-3144
Phone (210) 245-7862

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
I20240529000539 TX Practitioner - Mental Health Counselor 0244672855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Insight Mental Wellness PAGroup PAC ID 5496094039, 18 clinicians

Practice addresses (Care Compare)

10807 Perrin Beitel Rd
Suite 300
San Antonio, TX 78217-3144
Phone (210) 245-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75500TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Mental Wellness PA Professional CurrentSince May 17, 2024 Accepting new patients
Medvon Medical Clinic Professional Corporation PastSince May 17, 2024 Accepting new patients

Locations

10807 Perrin Beitel Rd
Ste 300
San Antonio, TX 78217
Phone (210) 245-7862

12915 Jones Maltsberger Rd
Ste 102
San Antonio, TX 78247
Phone (210) 245-7862

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, 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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1063920551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10807 PERN BETL RD STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173144",
            "telephone_number": "210-245-7862",
            "fax_number": "210-245-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 PERN BETL RD STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173144",
            "telephone_number": "210-245-7862",
            "fax_number": "210-245-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.