The Metamorphosis House

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

19069 Issued in TX

Legal business name

THE METAMORPHOSIS HOUSE

Practice address

829 N LBJ Dr
Suite 209
San Marcos, TX 78666-4694

Phone

(512) 217-6072

Fax

(512) 295-4595

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Cilly Jordan, LPC, LSOTP

Title

Executive Director

Phone

(512) 217-6072

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1326165622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N LBJ DR",
            "address_2": "SUITE 209",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786664694",
            "telephone_number": "512-217-6072",
            "fax_number": "512-295-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N LBJ DR",
            "address_2": "SUITE 209",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786664694",
            "telephone_number": "512-217-6072",
            "fax_number": "512-295-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE METAMORPHOSIS HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CILLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "512-217-6072",
        "authorized_official_credential": "LPC, LSOTP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "98981",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas State University
• Texas State University
• Texas State University Student Health Center
• Texas Total Health, Inc.
• The Clinic Neuropsychological & Psychological Services, PLLC
• Therapeutic Communities, LLC
• Therapy Nexus, PLLC
• Aleah Thomas
• Ashley M Thomas
• Elizabeth Thomas, IBCLC

• Professional Counselor in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.