Individual provider Active NPI

Lisa Renee Cantu

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1306558630
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
83004 Issued in TX
Practice address
21727 Ih 10 W Ste 106
San Antonio, TX 78257-2108
Phone
(855) 284-7483
Fax
(617) 807-0958
NPI assigned
Dec 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 83004 TX Primary

Addresses

Primary practice location

21727 Ih 10 W Ste 106
San Antonio, TX 78257-2108

Mailing address

PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483

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
I20231220004301 TX Practitioner - Mental Health Counselor 1658721352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050

4903 82nd St
Ste 60
Lubbock, TX 79424
Phone (806) 507-6934

21727 W Interstate 10
Ste 106
San Antonio, TX 78257
Phone (210) 535-9810

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1306558630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21727 IH 10 W STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782572108",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTU",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.