Individual provider Active NPI

Melissa Vermillion, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1225466162
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67842 Issued in TX
Practice address
3031 W Ih 10
San Antonio, TX 78201-5159
Phone
(210) 261-1000
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 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 67842 TX Primary

Addresses

Primary practice location

3031 W Ih 10
San Antonio, TX 78201-5159

Mailing address

12235 Vance Jackson Rd
Apt 435
San Antonio, TX 78230-5956
Phone (281) 630-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240216001835 TX Practitioner - Mental Health Counselor 7810331923 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida Behavioral Health Associates,Inc Professional CurrentSince Jan 14, 2024 Accepting new patients

Locations

102 Palo Alto Rd
Ste 300
San Antonio, TX 78211
Phone (210) 922-0828

700 S Zarzamora St
Ste 106
San Antonio, TX 78207
Phone (210) 338-5695

9500 Tioga Dr
Ste A
San Antonio, TX 78230
Phone (210) 616-0828

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1225466162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12235 VANCE JACKSON RD",
            "address_2": "APT 435",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305956",
            "telephone_number": "281-630-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W IH 10",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782015159",
            "telephone_number": "210-261-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMILLION",
        "first_name": "MELISSA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.