Individual provider Active NPI

Mary Carmen Calatayud, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1538487012
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC3322 Issued in MD
Practice address
8401 N New Braunfels Ave Apt 119
San Antonio, TX 78209-1110
Phone
(202) 210-9412
NPI assigned
May 9, 2010
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 83475 TX
Professional Counselor 101YP2500X LC3322 MD Primary

Addresses

Primary practice location

8401 N New Braunfels Ave Apt 119
San Antonio, TX 78209-1110

Mailing address

8401 N New Braunfels Ave Apt 119
San Antonio, TX 78209-1110
Phone (202) 210-9412

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carmenc@therapyemail.com Direct

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
I20240404002080 TX Practitioner - Mental Health Counselor 1254779671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jewish Family Service of San Antonio Texas IncGroup PAC ID 8325951155, 5 clinicians

Practice addresses (Care Compare)

12500 NW Military Hwy
Suite 250
San Antonio, TX 78231-2000
Phone (210) 302-6920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC3322MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of San Antonio Texas Inc. Professional CurrentSince Mar 15, 2024 Accepting new patients
Carol Albert PastSince Mar 15, 2024 Accepting new patients

Locations

12500 NW Military Hwy
Ste 250
San Antonio, TX 78231
Phone (210) 302-6920

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, 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": "1273363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1538487012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 N NEW BRAUNFELS AVE APT 119",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091110",
            "telephone_number": "202-210-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 N NEW BRAUNFELS AVE APT 119",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091110",
            "telephone_number": "202-210-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALATAYUD",
        "first_name": "MARY",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-09",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83475",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carmenc@therapyemail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8401 N New Braunfels Ave Apt 119",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782091110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.