Psychological Services, C.a.F.

Primary specialty

SpecialistTaxonomy code 174400000X

License

16060 Issued in TX

Legal business name

PSYCHOLOGICAL SERVICES, C.A.F.

Practice address

8930 Fourwinds Dr
Suite 247
San Antonio, TX 78239-1970

Phone

(210) 658-2280

Fax

(210) 945-7780

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Gloria Dean Fondren, LPC, LSOTP

Title

Chief Executive Officer, Consultant

Phone

(210) 658-2280

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1245384007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 FOURWINDS DR STE 247",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782391970",
            "telephone_number": "210-658-2280",
            "fax_number": "210-945-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 FOURWINDS DR",
            "address_2": "SUITE 247",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782391970",
            "telephone_number": "210-658-2280",
            "fax_number": "210-945-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES, C.A.F.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "FONDREN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER, CONSULTANT",
        "authorized_official_telephone_number": "210-658-2280",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, LSOTP"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "16060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219792-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "85278L",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PSP Family Care LLC
• Psych Today Inc
• Psychfit360
• Psychiatric Associates of San Antonio
• Psychiatric Inpatient Management Services, PLLC
• Psychotherapeutic Services
• PT Home Services of San Antonio Inc
• PT Home Services of San Antonio, Inc.
• Alisa Leron Puatu
• Felipe Andres Pubillones, DO

• Specialist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.