NPIMap

Organization Active NPI

Our Lady of the Lake University

Doing business as Community Counseling Service

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1588823199
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
62520 Issued in TX
Legal business name
OUR LADY OF THE LAKE UNIVERSITY
Doing business as
Community Counseling Service
Practice address
590 N General McMullen
3
San Antonio, TX 78228-6205
Phone
(210) 434-1054
Fax
(210) 434-1380
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mrs. Bernadette H Solorzano, PSYD
Title
Clinic Director
Phone
(210) 434-1054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 62520 TX Primary

Addresses

Primary practice location

590 N General McMullen
3
San Antonio, TX 78228-6205

Mailing address

590 N General McMullen
3
San Antonio, TX 78228-6205
Phone (210) 434-1054

Other identifiers 1

IdentifierTypeStateIssuer
144674201MedicaidTX

Other names 1

  • Community Counseling Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Harry Jersig Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1588823199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 N GENERAL MCMULLEN",
            "address_2": "3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782286205",
            "telephone_number": "210-434-1054",
            "fax_number": "210-434-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 N GENERAL MCMULLEN",
            "address_2": "3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782286205",
            "telephone_number": "210-434-1054",
            "fax_number": "210-434-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE LAKE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "SOLORZANO",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "210-434-1054",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144674201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 9, 2008; 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.