NPIMap

Organization Active NPI

Hill Country Christian Counseling Center, Inc.

  • Mental Health Counselor
  • Kerrville, TX
National Provider Identifier
1366440737
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18662 Issued in TX
Legal business name
HILL COUNTRY CHRISTIAN COUNSELING CENTER, INC.
Practice address
1127 Main St Ste 100
Kerrville, TX 78028-3581
Phone
(830) 257-3009
NPI assigned
Jul 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Brenda Fudge, DIRECTOR
Title
Director
Phone
(830) 257-3009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 18662 TX Primary

Addresses

Primary practice location

1127 Main St Ste 100
Kerrville, TX 78028-3581

Mailing address

1127 Main St Ste 100
Kerrville, TX 78028-3581
Phone (830) 257-3009

Other practice location 1

616 Barnett St
Kerrville, TX 78028-4518
Phone (830) 257-3009

Other identifiers 3

IdentifierTypeStateIssuer
0037GTOtherTXBLUE CROSS BLUE SHIELD
171632601MedicaidTX
7636153OtherTXAETNA

Other names 1

  • New Hope Counsleing Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050111000396 TX Part B Supplier - Clinic/Group Practice 1456309970 Receives reassigned benefits from 4 practitioners
Practice locations: Kerrville, TX

National Provider Directory

National Provider Directory
Tax ID family
Hill Country Christian2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1127 Main St
Ste 100
Kerrville, TX 78028
Phone (830) 257-3009

616 Barnett St
Kerrville, TX 78028
Phone (830) 257-3009

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1366440737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 MAIN ST STE 100",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283581",
            "telephone_number": "830-257-3009",
            "fax_number": "830-257-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 MAIN ST STE 100",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283581",
            "telephone_number": "830-257-3009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 Barnett St",
            "address_purpose": "LOCATION",
            "city": "Kerrville",
            "state": "TX",
            "postal_code": "780284518",
            "country_code": "US",
            "telephone_number": "830-257-3009",
            "fax_number": "830-257-3061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HILL COUNTRY CHRISTIAN COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "FUDGE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "830-257-3009",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0037GT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171632601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7636153",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Hope Counsleing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.