Active NPI
Michelle Brakhage
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1548787443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 77926
- Practice address
- 19115 FM 2252 Ste 4
San Antonio, TX 78266-2578 - Phone
- (210) 757-3150
- Fax
- (800) 508-0086
- NPI assigned
- Aug 23, 2017
- Last updated
- Feb 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 77926 | TX | Primary |
Addresses
Primary practice location
19115 FM 2252 Ste 4
San Antonio, TX 78266-2578
Mailing address
PO Box 34834
San Antonio, TX 78265-4834
Phone (210) 757-3150
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77926 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elizabeth Arredondo | Professional | Past | Accepting new patients |
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": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1548787443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34834",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782654834",
"telephone_number": "210-757-3150",
"fax_number": "800-508-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19115 FM 2252 STE 4",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782662578",
"telephone_number": "210-757-3150",
"fax_number": "800-508-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAKHAGE",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2024-02-02",
"certification_date": "2024-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "77926",
"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 Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.