Individual provider Active NPI

Mary (MK) Kathryn Lyssy, M.S., LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1508410051
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
79048 Issued in TX
Practice address
1102 Barclay St
San Antonio, TX 78207-7161
Phone
(210) 233-7000
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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 79048 TX Primary

Addresses

Primary practice location

1102 Barclay St
San Antonio, TX 78207-7161

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7000

Other practice location 1

6609 Blanco Rd Ste. 365
San Antonio, TX 78216
Phone (210) 777-7802

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
I20240412003733 TX Practitioner - Mental Health Counselor 8921447772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrio Comprehensive Family Health Care Center,IncGroup PAC ID 1153226691, 63 clinicians

Practice addresses (Care Compare)

430 W Bandera Rd
9 Communicare Health Centers
Boerne, TX 78006-2521
Phone 21023370627649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
79048TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 10, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 10, 2024 Accepting new patients

Locations

430 W Bandera Rd
Ste 9
Boerne, TX 78006
Phone (830) 249-7211

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

Interoperability endpoints

  • Direct secure messaging: mk.lyssy@commsa.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1508410051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-434-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BARCLAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077161",
            "telephone_number": "210-233-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6609 Blanco Rd Ste. 365",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78216",
            "country_code": "US",
            "telephone_number": "210-777-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYSSY",
        "first_name": "MARY (MK)",
        "middle_name": "KATHRYN",
        "credential": "M.S., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.