Active NPI
Nicole Terese Patrick, M.A., LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1497332175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 82039
- Practice address
- 6923 W Loop 1604 N Ste 119
San Antonio, TX 78254-2631 - Phone
- (210) 446-6454
- Fax
- (210) 314-4671
- NPI assigned
- Mar 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 82039 | TX | Primary |
Addresses
Primary practice location
6923 W Loop 1604 N Ste 119
San Antonio, TX 78254-2631
Mailing address
3030 Fall Mist Dr
San Antonio, TX 78247-3228
Phone (848) 216-6368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Professional | Current | Accepting new patients |
| Grit & Grace Counseling, PLLC | Professional | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391
Organizations & group practices 2
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": "1616803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616803200000",
"number": "1497332175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 FALL MIST DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782473228",
"telephone_number": "848-216-6368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6923 W LOOP 1604 N STE 119",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782542631",
"telephone_number": "210-446-6454",
"fax_number": "210-314-4671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "NICOLE",
"middle_name": "TERESE",
"credential": "M.A., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-27",
"last_updated": "2021-03-27",
"certification_date": "2021-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "82039",
"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 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.