Individual provider Active NPI

Andrea Lynne Scott, MA, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1194878850
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
19341 Issued in TX
Practice address
130 Alta Ave
San Antonio, TX 78209-4509
Phone
(210) 827-5968
Fax
(210) 783-8247
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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 19341 TX Primary

Addresses

Primary practice location

130 Alta Ave
San Antonio, TX 78209-4509

Mailing address

130 Alta Ave
San Antonio, TX 78209-4509
Phone (210) 827-5968

Other practice location 1

1634 Lockhill Selma Rd
San Antonio, TX 78213-1929
Phone (210) 827-5968

Other identifiers 2

IdentifierTypeStateIssuer
178537001MedicaidTX
080101101MedicaidTX

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

LicenseStateTypeSpecialty
19341TXMDMusic Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1194878850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ALTA AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094509",
            "telephone_number": "210-827-5968",
            "fax_number": "210-783-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ALTA AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094509",
            "telephone_number": "210-827-5968",
            "fax_number": "210-783-8247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1634 Lockhill Selma Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782131929",
            "country_code": "US",
            "telephone_number": "210-827-5968",
            "fax_number": "210-783-8247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ANDREA",
        "middle_name": "LYNNE",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178537001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080101101",
            "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 Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.