Individual provider Active NPI

Amaranta Penate-Marty

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1417456773
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
73435 Issued in TX
Practice address
620 E Afton Oaks Blvd
San Antonio, TX 78232-1236
Phone
(210) 568-8600
NPI assigned
Feb 1, 2018
Last updated
Feb 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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 73435 TX Primary

Addresses

Primary practice location

620 E Afton Oaks Blvd
San Antonio, TX 78232-1236

Mailing address

620 E Afton Oaks Blvd
San Antonio, TX 78232-1236

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
I20240516000650 TX Practitioner - Mental Health Counselor 8123469590 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desta Therapy, LLCGroup PAC ID 8224566708, 9 clinicians

Practice addresses (Care Compare)

16607 Blanco Rd
Suite 12103
San Antonio, TX 78232-1961
Phone (210) 417-9272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73435TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Behavioral Health, PLLC Professional CurrentSince Jul 15, 2024 Accepting new patients
Deer Oaks Geriatric Services P C CurrentSince May 1, 2024 Accepting new patients
Desta Therapy, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1314 E Sonterra Blvd
Ste 2208
San Antonio, TX 78258
Phone 2108581900 ext. 303

16607 Blanco Rd
Ste 12103
San Antonio, TX 78232
Phone (210) 417-7292

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1417456773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E AFTON OAKS BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E AFTON OAKS BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321236",
            "telephone_number": "210-568-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENATE-MARTY",
        "first_name": "AMARANTA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.