Active NPI
Mary E Pena, L.P.C.
- Counselor
- San Juan, TX
National Provider Identifier
1083739197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 61089
- Practice address
- 801 W. 1St Street
San Juan, TX 78589-2276 - Phone
- (956) 631-9000
- Fax
- (956) 631-9013
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61089 | TX | |
| Counselor | 101Y00000X | 61089 | TX | Primary |
Addresses
Primary practice location
801 W. 1St Street
San Juan, TX 78589-2276
Mailing address
801 W. 1St Street
San Juan, TX 78589-2276
Phone (956) 787-8915
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181047501 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61089 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1083739197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 W. 1ST STREET",
"city": "SAN JUAN",
"state": "TX",
"postal_code": "785892276",
"telephone_number": "956-787-8915",
"fax_number": "956-787-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W. 1ST STREET",
"city": "SAN JUAN",
"state": "TX",
"postal_code": "785892276",
"telephone_number": "956-631-9000",
"fax_number": "956-631-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "MARY",
"middle_name": "E",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "61089",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "61089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181047501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.