Organization Active NPI

The McCullough Center for Mental Health Services Inc

Doing business as McCullough Center For Mental Health Services

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1275790438
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19585 Issued in TX
Legal business name
THE MCCULLOUGH CENTER FOR MENTAL HEALTH SERVICES INC
Doing business as
McCullough Center For Mental Health Services
Practice address
2515 McCullough Ave Ste 101
San Antonio, TX 78212-3585
Phone
(210) 736-1762
Fax
(210) 736-3156
NPI assigned
May 16, 2008
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Ceasar Garza, LPCNPI 1477521904
Title
President
Phone
(210) 736-1762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 19585 TX Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

2515 McCullough Ave Ste 101
San Antonio, TX 78212-3585

Mailing address

2515 McCullough Ave Ste 101
San Antonio, TX 78212-3585
Phone (210) 736-1762

Other identifiers 6

IdentifierTypeStateIssuer
198721601MedicaidTX
1477521904OtherINDIVIDUAL NPI
174358502MedicaidTX
198721602MedicaidTX
909681OtherMEDICARE
1275790438OtherGROUP NPI

Other names 1

  • McCullough Center For Mental Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200131001719 TX Part B Supplier - Clinic/Group Practice 1850727363 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2515 McCullough Ave
Ste 101
San Antonio, TX 78212
Phone (210) 736-1762

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1275790438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 MCCULLOUGH AVE STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782123585",
            "telephone_number": "210-736-1762",
            "fax_number": "210-736-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 MCCULLOUGH AVE STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782123585",
            "telephone_number": "210-736-1762",
            "fax_number": "210-736-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MCCULLOUGH CENTER FOR MENTAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "GARZA",
        "authorized_official_first_name": "CEASAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-736-1762",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "19585",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198721601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1477521904",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174358502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198721602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "909681",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1275790438",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCullough Center For Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 16, 2025; 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.