Suzette M Sova-Robertson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

61164 Issued in TX

Practice address

18707 Hardy Oak Blvd Ste 410
San Antonio, TX 78258-4841

Phone

(210) 503-1729

Fax

(855) 420-6402

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
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  • NPI 1245845932

  Professional

  NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1154462349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 WURZBACH RD # 225",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302214",
            "telephone_number": "512-730-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18707 HARDY OAK BLVD STE 410",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584841",
            "telephone_number": "210-503-1729",
            "fax_number": "855-420-6402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13290 Old Corpus Christi Rd",
            "address_purpose": "LOCATION",
            "city": "Elmendorf",
            "state": "TX",
            "postal_code": "781129602",
            "country_code": "US",
            "telephone_number": "210-781-7136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13290 Old Corpus Christi Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78112",
            "country_code": "US",
            "telephone_number": "512-730-0229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOVA-ROBERTSON",
        "first_name": "SUZETTE",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2023-10-04",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "61164",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186073601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.