Individual provider Active NPI

Marina Vladimir, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1255972808
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
77263 Issued in TX
Practice address
928 W Commerce St
San Antonio, TX 78207-4444
Phone
(210) 261-1200
Fax
(210) 261-3723
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 77263 TX Primary

Addresses

Primary practice location

928 W Commerce St
San Antonio, TX 78207-4444

Mailing address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293
Phone (210) 261-1000

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77263TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Jan 1, 2024 Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

928 W Commerce St
San Antonio, TX 78207
Phone (210) 261-1200

6800 Park Ten Blvd
Ste 200S
San Antonio, TX 78213
Phone 21026110001060

Organizations & group practices 2

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": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1255972808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782074444",
            "telephone_number": "210-261-1200",
            "fax_number": "210-261-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLADIMIR",
        "first_name": "MARINA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.