Active NPI
Citlaly Fernandez, M.A., LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1104955095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61092
- Practice address
- 5555 Fredericksburg Rd Ste 102
San Antonio, TX 78229-3500 - Phone
- (210) 616-0828
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 61092 | TX | Primary |
Addresses
Primary practice location
5555 Fredericksburg Rd Ste 102
San Antonio, TX 78229-3500
Mailing address
21511 Granite SPG
San Antonio, TX 78258-6913
Phone (210) 497-1397
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61092 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nueva Vida Behavioral Health Associates,Inc | Professional | Past | Accepting new patients |
| Alamo Area Family & Geriatric Medicine Associates, PA | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Windcrest, TX
- NPI 1366575706
-
- Professional Counselor
- San Antonio, TX
- NPI 1669565529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104955095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21511 GRANITE SPG",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782586913",
"telephone_number": "210-497-1397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 FREDERICKSBURG RD STE 102",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293500",
"telephone_number": "210-616-0828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "CITLALY",
"name_prefix": "Mrs.",
"credential": "M.A., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "61092",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.