Individual provider Active NPI

Carmen Casares-Cernoch, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1376765354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
61557 Issued in TX
Practice address
527 N Leona St
San Antonio, TX 78207-3110
Phone
(210) 225-5481
Fax
(210) 358-6903
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 61557 TX Primary

Addresses

Primary practice location

527 N Leona St
San Antonio, TX 78207-3110

Mailing address

3031 W Ih 10
San Antonio, TX 78201-5159
Phone (210) 731-1300

Other identifiers 1

IdentifierTypeStateIssuer
61557OtherTXLICENSED PROFESSIONAL COU

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
I20240508003877 TX Practitioner - Mental Health Counselor 2567803521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61557TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Apr 3, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376765354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W IH 10",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782015159",
            "telephone_number": "210-731-1300",
            "fax_number": "210-731-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 N LEONA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073110",
            "telephone_number": "210-225-5481",
            "fax_number": "210-358-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASARES-CERNOCH",
        "first_name": "CARMEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COU",
            "identifier": "61557",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.