Individual provider Active NPI

Deborah Ann Hermosa, L.P.C.

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1093938847
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11904 Issued in TX
Practice address
10974 Hamlen Park Dr S
San Antonio, TX 78249-4117
Phone
(210) 697-9175
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 11904 TX Primary

Addresses

Primary practice location

10974 Hamlen Park Dr S
San Antonio, TX 78249-4117

Mailing address

10974 Hamlen Park Dr S
San Antonio, TX 78249-4117
Phone (210) 697-9175

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
I20240111002830 TX Practitioner - Mental Health Counselor 2365893591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nueva Vida Behavioral Health Associates, IncGroup PAC ID 1052540176, 35 clinicians

Practice addresses (Care Compare)

9500 Tioga Dr
Suite a
San Antonio, TX 78230-3118
Phone (210) 616-0828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11904TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida Behavioral Health Associates,Inc Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

9500 Tioga Dr
Ste A
San Antonio, TX 78230
Phone (210) 616-0828

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093938847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10974 HAMLEN PARK DR S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494117",
            "telephone_number": "210-697-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10974 HAMLEN PARK DR S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494117",
            "telephone_number": "210-697-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMOSA",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "11904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.