Individual provider Active NPI

Tamara L. Mobley-Wicker

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1437899184
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
18793 Issued in TX
Practice address
4119 Knollbluff
San Antonio, TX 78247-2108
Phone
(210) 823-4958
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 18793 TX Primary

Addresses

Primary practice location

4119 Knollbluff
San Antonio, TX 78247-2108

Mailing address

4119 Knollbluff
San Antonio, TX 78247-2108
Phone (210) 823-4958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18793TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1437899184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 KNOLLBLUFF",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782472108",
            "telephone_number": "210-823-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 KNOLLBLUFF",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782472108",
            "telephone_number": "210-823-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY-WICKER",
        "first_name": "TAMARA",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.