Active NPI
Stacia Marie Daniel, PH.D.
- Counseling Psychologist
- San Antonio, TX
National Provider Identifier
1104849751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 30792
- Practice address
- 21714 Hardy Oak Blvd
Unit #104
San Antonio, TX 78258-4838 - Phone
- (210) 490-9062
- NPI assigned
- Jul 25, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 30792 | TX | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 30792 | TX | |
| Counseling Psychologist | 103TC1900X | 30792 | TX | Primary |
| Health Service Psychologist | 103TH0100X | 30792 | TX |
Addresses
Primary practice location
21714 Hardy Oak Blvd
Unit #104
San Antonio, TX 78258-4838
Mailing address
21714 Hardy Oak Blvd
Unit #104
San Antonio, TX 78258-4838
Phone (210) 490-9062
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1794141 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Aug 1, 2012 through Aug 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30792 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1104849751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21714 HARDY OAK BLVD",
"address_2": "UNIT #104",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782584838",
"telephone_number": "210-490-9062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21714 HARDY OAK BLVD",
"address_2": "UNIT #104",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782584838",
"telephone_number": "210-490-9062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "STACIA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "30792",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "TX",
"license": "30792",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "30792",
"primary": true
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "TX",
"license": "30792",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1794141",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.