Individual provider Active NPI

Ember Shad Loeffler

  • Professional Counselor
  • San Angelo, TX
National Provider Identifier
1396319273
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433
Phone
(325) 944-2561
Fax
(325) 939-2019
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433

Mailing address

36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433
Phone (325) 944-2561

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

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1396319273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E TWOHIG AVE STE 600",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036433",
            "telephone_number": "325-944-2561",
            "fax_number": "325-939-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E TWOHIG AVE STE 600",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036433",
            "telephone_number": "325-944-2561",
            "fax_number": "325-939-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEFFLER",
        "first_name": "EMBER",
        "middle_name": "SHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.