Roxanne Maynard, LPC, LCDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

73188 Issued in TX

Practice address

4203 Gardendale St Ste C214
San Antonio, TX 78229

Phone

(210) 243-0693

Fax

(877) 287-0053

NPI assigned

Jul 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1407102718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 GARDENDALE ST STE C214",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293174",
            "telephone_number": "210-243-0693",
            "fax_number": "877-287-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 GARDENDALE ST STE C214",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-243-0693",
            "fax_number": "877-287-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "ROXANNE",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "73188",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5444",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351033101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayfield Care Center
• Cheyene Nicole Mayfield
• Mia Mayfield
• Chasity Shameel Mayhon
• Freya H Maynard, PT
• Lisa Gail Maynes, LCSW
• Christian Mayo, APRN, AGACNP-BC
• David Drake Mayon
• Jessica Mayor, MD
• Jaime Lopez Mayoral, MD

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.