Individual provider Active NPI

McKenzie Koester, LPC ASSOCIATE

  • Counselor
  • San Antonio, TX
National Provider Identifier
1508517731
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
83812 Issued in TX
Practice address
11467 Huebner Rd Ste 251
San Antonio, TX 78230-1073
Phone
(210) 376-1314
NPI assigned
Jan 10, 2022
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 83812 TX Primary

Addresses

Primary practice location

11467 Huebner Rd Ste 251
San Antonio, TX 78230-1073

Mailing address

11467 Huebner Rd Ste 251
San Antonio, TX 78230-1073
Phone (210) 376-1314

Other identifiers 1

IdentifierTypeStateIssuer
83812OtherTXTEXAS STATE BOARD OF EXAMINERS COUNSELOR

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 21, 2024 through Mar 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
83812TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Path of Counseling Counselor CurrentSince Jul 9, 2023 Accepting new patients

Locations

11467 Huebner Rd
Ste 251
San Antonio, TX 78230
Phone (210) 683-4313

Organizations & group practices 1

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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1508517731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11467 HUEBNER RD STE 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301073",
            "telephone_number": "210-376-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11467 HUEBNER RD STE 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301073",
            "telephone_number": "210-376-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTER",
        "first_name": "MCKENZIE",
        "credential": "LPC ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "83812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF EXAMINERS COUNSELOR",
            "identifier": "83812",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.