Individual provider Active NPI

Melanie E Gomez

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1316460967
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
81246 Issued in TX
Practice address
1747 Citadel PLZ Ste 205
San Antonio, TX 78209-1017
Phone
(210) 467-5395
Fax
(210) 817-1114
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 81246 TX Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13828 TX

Addresses

Primary practice location

1747 Citadel PLZ Ste 205
San Antonio, TX 78209-1017

Mailing address

1747 Citadel PLZ Ste 205
San Antonio, TX 78209-1017
Phone (210) 467-5395

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
13828TXMDPublic Health Dentist
81246TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Innovations Counseling Services, PLLC Addiction (Substance Use Disorder) CurrentSince Jan 17, 2022 Accepting new patients
Bexar County Board of Trustess for Mental Health and Mental Retardatio Past Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation Past Accepting new patients

Locations

1747 Citadel Plz
Ste 205
San Antonio, TX 78209
Phone (210) 251-6645

Organizations & group practices 3

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1316460967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 CITADEL PLZ STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091017",
            "telephone_number": "210-467-5395",
            "fax_number": "210-817-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 CITADEL PLZ STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091017",
            "telephone_number": "210-467-5395",
            "fax_number": "210-817-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MELANIE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "81246",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13828",
            "primary": false
        }
    ],
    "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 Jan 4, 2022; 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.