Individual provider Active NPI

Deborah Demerson, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
National Provider Identifier
1316297112
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11423 Issued in TX
Practice address
4000 Horizon Hill Blvd Apt 2107
2107
San Antonio, TX 78229-2227
Phone
(830) 377-1726
Fax
(210) 257-8807
NPI assigned
Sep 19, 2012
Last updated
May 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11423 TX Primary

Addresses

Primary practice location

4000 Horizon Hill Blvd Apt 2107
2107
San Antonio, TX 78229-2227

Mailing address

4000 Horizon Hill Blvd Apt 2107
2107
San Antonio, TX 78229-2227
Phone (830) 377-1726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11423TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1316297112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HORIZON HILL BLVD APT 2107",
            "address_2": "2107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292227",
            "telephone_number": "830-377-1726",
            "fax_number": "210-257-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HORIZON HILL BLVD APT 2107",
            "address_2": "2107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292227",
            "telephone_number": "830-377-1726",
            "fax_number": "210-257-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERSON",
        "first_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11423",
            "primary": true
        }
    ],
    "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 May 9, 2014; 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.