Individual provider Active NPI

Brian Lee Sharp, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1114264587
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
66868 Issued in TX
Practice address
4615 Walzem Rd
Ste 208
San Antonio, TX 78218-1667
Phone
(210) 267-8993
Fax
(210) 267-9243
NPI assigned
Jan 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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 66868 TX Primary

Addresses

Primary practice location

4615 Walzem Rd
Ste 208
San Antonio, TX 78218-1667

Mailing address

4615 Walzem Rd
Ste 208
San Antonio, TX 78218-1667
Phone (210) 267-8993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240802003761 FL Practitioner - Mental Health Counselor 7618414053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6092CTMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1357344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1114264587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 WALZEM RD",
            "address_2": "STE 208",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782181667",
            "telephone_number": "210-267-8993",
            "fax_number": "210-267-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 WALZEM RD",
            "address_2": "STE 208",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782181667",
            "telephone_number": "210-267-8993",
            "fax_number": "210-267-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-05",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "66868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.