Individual provider Active NPI

Teri Johnson

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1417323197
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
71328 Issued in TX
Practice address
4318 Woodcock Dr Ste 120
San Antonio, TX 78228-1315
Phone
(210) 571-4471
Fax
(210) 547-0256
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 71328 TX Primary
Mental Health Counselor 101YM0800X 71328 TX

Addresses

Primary practice location

4318 Woodcock Dr Ste 120
San Antonio, TX 78228-1315

Mailing address

4318 Woodcock Dr Ste 120
San Antonio, TX 78228-1315
Phone (210) 571-4471

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
I20240403002007 TX Practitioner - Mental Health Counselor 7214375732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4100 E Piedras Dr
Suite 140
San Antonio, TX 78228-1425
Phone (210) 571-4471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71328TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Counseling Services Inc Professional CurrentSince Mar 15, 2024 Accepting new patients

Locations

4100 E Piedras Dr
Ste 140
San Antonio, TX 78228
Phone (210) 544-3719

4318 Woodcock Dr
Ste 120
San Antonio, TX 78228
Phone (210) 571-4471

Organizations & group practices 1

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1417323197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 WOODCOCK DR STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281315",
            "telephone_number": "210-571-4471",
            "fax_number": "210-547-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 WOODCOCK DR STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281315",
            "telephone_number": "210-571-4471",
            "fax_number": "210-547-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71328",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "71328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.