Individual provider Active NPI

Marie Lewis

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1336786680
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
82727 Issued in TX
Practice address
20079 Stone Oak Pkwy Ste 1275
San Antonio, TX 78258-6983
Phone
(210) 481-3727
NPI assigned
Dec 5, 2019
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 82727 TX Primary

Addresses

Primary practice location

20079 Stone Oak Pkwy Ste 1275
San Antonio, TX 78258-6983

Mailing address

PO Box 56
Converse, TX 78109-0056
Phone (757) 805-0339

Other practice location 1

4201 Medical Dr Ste 330
San Antonio, TX 78229-5805
Phone (210) 614-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250529002647 NC Practitioner - Mental Health Counselor 9335668623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Better Care Health LLCGroup PAC ID 5496239576, 2 clinicians

Practice addresses (Care Compare)

317 Matthews Mint Hill Rd
Suite 109
Matthews, NC 28105-2894
Phone (704) 516-8166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
82727TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Associates of South Texas Professional CurrentSince Feb 2, 2020 Accepting new patients
Southeast Psychological Services, PLLC CurrentSince May 8, 2025 Accepting new patients

Locations

6060 Piedmont Row Dr S
Ste 120
Charlotte, NC 28287
Phone (704) 552-0116

20079 Stone Oak Pkwy
Ste 1275
San Antonio, TX 78258
Phone (210) 481-3727

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, 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": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1336786680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781090056",
            "telephone_number": "757-805-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20079 STONE OAK PKWY STE 1275",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782586983",
            "telephone_number": "210-481-3727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Medical Dr Ste 330",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782295805",
            "country_code": "US",
            "telephone_number": "210-614-4990",
            "fax_number": "210-614-4991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.