Individual provider Active NPI

Kirleen Neely, PHD, LPC-S

  • Marriage & Family Therapist
  • San Antonio, TX
National Provider Identifier
1548376387
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
16484 Issued in TX
Practice address
11153 Westwood Loop Ste 122
San Antonio, TX 78253-6766
Phone
(210) 414-8949
NPI assigned
Aug 22, 2006
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 16484 TX
Marriage & Family Therapist 106H00000X 16484 TX Primary

Addresses

Primary practice location

11153 Westwood Loop Ste 122
San Antonio, TX 78253-6766

Mailing address

12030 Bandera Rd Ste D
Helotes, TX 78023-4735
Phone (210) 523-4200

Other identifiers 1

IdentifierTypeStateIssuer
096034601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16484TXMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neely Behavioral Health CurrentSince Dec 12, 2021 Accepting new patients

Locations

12030 Bandera Rd
Ste D
Helotes, TX 78023
Phone (210) 523-4200

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1548376387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 BANDERA RD STE D",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234735",
            "telephone_number": "210-523-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11153 WESTWOOD LOOP STE 122",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782536766",
            "telephone_number": "210-414-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELY",
        "first_name": "KIRLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "16484",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "16484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096034601",
            "state": "TX"
        }
    ],
    "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 Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.