Individual provider Active NPI

Clifton Nelson Taylor, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1598075129
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
65007 Issued in TX
Practice address
401 E Sonterra Blvd Ste 375
San Antonio, TX 78258-4321
Phone
(210) 378-0480
Fax
(210) 231-0832
NPI assigned
Oct 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 65007 TX Primary

Addresses

Primary practice location

401 E Sonterra Blvd Ste 375
San Antonio, TX 78258-4321

Mailing address

401 E Sonterra Blvd Ste 375
San Antonio, TX 78258-4321
Phone (210) 378-0480

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
I20250120000233 TX Practitioner - Mental Health Counselor 5193254258 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1023 La Tierra
San Antonio, TX 78258-3606

401 E Sonterra Blvd
Suite 375
San Antonio, TX 78258-4321
Phone (210) 378-0480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65007TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1287273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1598075129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E SONTERRA BLVD STE 375",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584321",
            "telephone_number": "210-378-0480",
            "fax_number": "210-231-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SONTERRA BLVD STE 375",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584321",
            "telephone_number": "210-378-0480",
            "fax_number": "210-231-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CLIFTON",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-17",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.