NPIMap

Organization Active NPI

Mindful Innovations Counseling Services, PLLC

  • Multi-Specialty Clinic/Center
  • San Antonio, TX
National Provider Identifier
1487055992
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MINDFUL INNOVATIONS COUNSELING SERVICES, PLLC
Practice address
1747 Citadel PLZ Ste 205
San Antonio, TX 78209
Phone
(210) 467-5395
NPI assigned
Sep 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Mr. Guillermo Rodriguez, LCDCNPI 1295833770
Title
Owner
Phone
(210) 788-2762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X TX
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1747 Citadel PLZ Ste 205
San Antonio, TX 78209

Mailing address

1747 Citadel PLZ Ste 205
San Antonio, TX 78209-1017
Phone (210) 467-5395

Other practice location 1

2819 Woodcliffe St
217
San Antonio, TX 78230-5143
Phone (210) 788-2762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211115000786 TX Part B Supplier - Clinic/Group Practice 5092104935 Receives reassigned benefits from 6 practitioners
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2267178Mindful Innovations Counseling Service1747 Citadel Plaza Ste 205, San Antonio, TX 78209Certificate of waiverAug 21, 2026

National Provider Directory

National Provider Directory

Locations

2819 Woodcliffe St
#217
San Antonio, TX 78230
Phone (210) 788-2762

1747 Citadel Plz
Ste 205
San Antonio, TX 78209
Phone (210) 251-6645

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1487055992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 CITADEL PLZ STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091017",
            "telephone_number": "210-467-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 CITADEL PLZ STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78209",
            "telephone_number": "210-467-5395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2819 Woodcliffe St",
            "address_2": "217",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782305143",
            "country_code": "US",
            "telephone_number": "210-788-2762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL INNOVATIONS COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-788-2762",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "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 Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.