NPIMap

Organization Active NPI

It's Life Counseling and Wellness PLLC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1578138236
Registry record updated Dec 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
IT'S LIFE COUNSELING AND WELLNESS PLLC
Practice address
85 NE Loop 410 Ste 223
San Antonio, TX 78216-5829
Phone
(210) 552-0985
NPI assigned
May 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2023

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

Authorized official

Name
Casey Tully, LPCNPI 1174827455
Title
Licensed Professional Counselor
Phone
(210) 380-3550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

85 NE Loop 410 Ste 223
San Antonio, TX 78216-5829

Mailing address

85 NE Loop 410 Ste 223
San Antonio, TX 78216-5829
Phone (210) 552-0985

Other practice location 1

25343 Longbranch Rd
San Antonio, TX 78261
Phone (210) 552-0985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240522002418 TX Part B Supplier - Clinic/Group Practice 5991148801 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

85 NE Loop 410
Ste 223
San Antonio, TX 78216
Phone (210) 552-0985

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702166400000",
    "number": "1578138236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410 STE 223",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165829",
            "telephone_number": "210-552-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410 STE 223",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165829",
            "telephone_number": "210-552-0985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25343 Longbranch Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78261",
            "country_code": "US",
            "telephone_number": "210-552-0985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IT'S LIFE COUNSELING AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A",
        "authorized_official_last_name": "TULLY",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "210-380-3550",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "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 Dec 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.