NPIMap

Organization Active NPI

Affective Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Braunfels, TX
National Provider Identifier
1396354874
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
AFFECTIVE MENTAL WELLNESS LLC
Practice address
705 Landa St Ste E
New Braunfels, TX 78130-6163
Phone
(210) 360-1590
Fax
(210) 855-9300
NPI assigned
Jul 30, 2020
Last updated
Aug 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Sara L Koenig-Langston, APRN, PMHNP-BCNPI 1265095061
Title
Owner
Phone
(210) 360-1590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

705 Landa St Ste E
New Braunfels, TX 78130-6163

Mailing address

705 Landa St Ste E
New Braunfels, TX 78130-6163
Phone (210) 360-1590

Other practice location 1

309 Brook Shadow
Cibolo, TX 78108-3434
Phone (210) 360-1590 ext. 1

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200817002352 TX Part B Supplier - Clinic/Group Practice 9931525375 Receives reassigned benefits from 4 practitioners
Practice locations: New Braunfels, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1396354874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 LANDA ST STE E",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306163",
            "telephone_number": "210-360-1590",
            "fax_number": "210-855-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LANDA ST STE E",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306163",
            "telephone_number": "210-360-1590",
            "fax_number": "210-855-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Brook Shadow",
            "address_purpose": "LOCATION",
            "city": "Cibolo",
            "state": "TX",
            "postal_code": "781083434",
            "country_code": "US",
            "telephone_number": "210-360-1590 x1",
            "fax_number": "210-855-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AFFECTIVE MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "KOENIG-LANGSTON",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-360-1590",
        "authorized_official_credential": "APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.