NPIMap

Organization Active NPI

Behavioral Support & Nursing Services, LLC

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1235768250
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BEHAVIORAL SUPPORT & NURSING SERVICES, LLC
Practice address
1600 NE Loop 410 Ste 105
San Antonio, TX 78209-1612
Phone
(210) 246-2334
NPI assigned
Apr 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Authorized official

Name
Angie Mattingly
Title
Manager Provider Enrollment
Phone
(502) 381-3579

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

1600 NE Loop 410 Ste 105
San Antonio, TX 78209-1612

Mailing address

805 N Whittington Pkwy
Louisville, KY 40222-5186
Phone (502) 394-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210125001822 TX Part B Supplier - Clinic/Group Practice 0941539886 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: San Antonio, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1600 NE Loop 410
Ste 105
San Antonio, TX 78209
Phone (210) 246-2334

1600 NE Loop 410
Ste 114
San Antonio, TX 78209
Phone (210) 370-3099

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1235768250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N WHITTINGTON PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225186",
            "telephone_number": "502-394-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 NE LOOP 410 STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091612",
            "telephone_number": "210-246-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL SUPPORT & NURSING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-02",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "502-381-3579"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.