Individual provider Active NPI

Kimberly Samaniego, LPC ASSOCIATE

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1407763758
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
102197 Issued in TX
Practice address
2602 Mud Lake Dr
San Antonio, TX 78245-2244
Phone
(210) 848-2899
NPI assigned
Aug 24, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 102197 TX Primary

Addresses

Primary practice location

2602 Mud Lake Dr
San Antonio, TX 78245-2244

Mailing address

2602 Mud Lake Dr
San Antonio, TX 78245-2244
Phone (210) 848-2899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1407763758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 MUD LAKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782452244",
            "telephone_number": "210-848-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 MUD LAKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782452244",
            "telephone_number": "210-848-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "LPC ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "102197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.