Individual provider Active NPI

Gloria Jean Mendez-Ybanez, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1396896874
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
15665 Issued in TX
Practice address
4203 Woodcock Dr
Suite 265
San Antonio, TX 78228-1320
Phone
(210) 737-2674
Fax
(210) 734-2412
NPI assigned
Jan 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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 15665 TX Primary

Addresses

Primary practice location

4203 Woodcock Dr
Suite 265
San Antonio, TX 78228-1320

Mailing address

4203 Woodcock Dr
Suite 265
San Antonio, TX 78228-1320
Phone (210) 737-2674

Other identifiers 2

IdentifierTypeStateIssuer
0288508-03MedicaidTX
0288508-04MedicaidTX

Other names 1

  • Gloria Jean Mendez Former name

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
I20240129001416 TX Practitioner - Mental Health Counselor 1153794532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendez Counseling Centers PLLCGroup PAC ID 8426421801, 3 clinicians

Practice addresses (Care Compare)

8207 Callaghan Rd
Suite 350
San Antonio, TX 78230-4737
Phone (210) 418-2094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15665TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mendez Counseling Centers, PLLC CurrentSince Jun 1, 2022 Accepting new patients
A-Omega Inc Past Accepting new patients

Locations

8207 Callaghan Rd
Ste 350
San Antonio, TX 78230
Phone (210) 418-2094

4242 Medical Dr
Ste 3200
San Antonio, TX 78229
Phone (210) 418-2094

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1396896874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR",
            "address_2": "SUITE 265",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281320",
            "telephone_number": "210-737-2674",
            "fax_number": "210-734-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR",
            "address_2": "SUITE 265",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281320",
            "telephone_number": "210-737-2674",
            "fax_number": "210-734-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ-YBANEZ",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288508-03",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288508-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "MENDEZ",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.