Individual provider Active NPI

Andrea Kubicek, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1356126437
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
99725 Issued in TX
Practice address
12803 West Ave
#3105
San Antonio, TX 78216
Phone
(501) 422-3219
NPI assigned
Aug 28, 2023
Last updated
Sep 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P2505013 AR
Mental Health Counselor 101YM0800X LPC.0024708 CO
Professional Counselor 101YP2500X 99725 TX Primary

Addresses

Primary practice location

12803 West Ave
#3105
San Antonio, TX 78216

Mailing address

12803 West Ave
#3105
San Antonio, TX 78216-1817
Phone (501) 422-3219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250924001654 TX Practitioner - Mental Health Counselor 2466957154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12803 W Ave
Apt 3105
San Antonio, TX 78216-1817

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling Associates Inc. CurrentSince Jul 1, 2017 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Sep 9, 2025 Accepting new patients

Locations

405 N 2nd St
Cabot, AR 72023
Phone (501) 221-1843

4354 Stockton Dr
North Little Rock, AR 72117
Phone (501) 221-1843

600 Congress Ave
Austin, TX 78701
Phone (281) 330-3059

Organizations & group practices 2

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1356126437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12803 WEST AVE",
            "address_2": "#3105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161817",
            "telephone_number": "501-422-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12803 WEST AVE",
            "address_2": "#3105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78216",
            "telephone_number": "501-422-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICEK",
        "first_name": "ANDREA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2505013",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0024708",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "99725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.