Active NPI
Berekat Beyene Petros, LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1336664556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 71956
- Practice address
- 16806 Maple Glade
San Antonio, TX 78247-2044 - Phone
- (210) 577-2068
- NPI assigned
- Aug 9, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 71956 | TX | Primary |
Addresses
Primary practice location
16806 Maple Glade
San Antonio, TX 78247-2044
Mailing address
16806 Maple Glade
San Antonio, TX 78247-2044
Phone (210) 577-2068
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
| License | State | Type | Specialty |
|---|---|---|---|
| 71956 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1336664556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16806 MAPLE GLADE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782472044",
"telephone_number": "210-577-2068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16806 MAPLE GLADE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782472044",
"telephone_number": "210-577-2068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROS",
"first_name": "BEREKAT",
"middle_name": "BEYENE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "71956",
"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 Jul 21, 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.