Active NPI
Christina Marie Song
- Marriage & Family Therapist
- San Antonio, TX
National Provider Identifier
1609451970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT4091
- Practice address
- 1203 Austin St Unit 1442
San Antonio, TX 78208-1186 - Phone
- (954) 801-6830
- NPI assigned
- Mar 17, 2021
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 204266 | TX | |
| Marriage & Family Therapist | 106H00000X | 2025024980 | MO | |
| Marriage & Family Therapist | 106H00000X | MT4091 | FL | Primary |
| Marriage & Family Therapist | 106H00000X | 37FL00248400 | NJ | |
| Mental Health Counselor | 101YM0800X | MH19309 | FL | |
| Marriage & Family Therapist | 106H00000X | MFT.0002777 | CO |
Addresses
Primary practice location
1203 Austin St Unit 1442
San Antonio, TX 78208-1186
Mailing address
1203 Austin St Unit 1442
San Antonio, TX 78208-1186
Phone (954) 801-6830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 3, 2024 through Oct 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH19309 | FL | MD | Mental Health Counselor |
| MFT.0002777 | CO | MD | Marriage & Family Therapist |
| MT4091 | FL | MD | Marriage & Family Therapist |
| 2025024980 | MO | MD | Marriage & Family Therapist |
| 37FL00248400 | NJ | MD | Marriage & Family Therapist |
| 204266 | TX | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ember & Bloom Therapy Co, PLLC | Marriage & Family Therapist | Current | 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 and National Provider Directory roles.
-
- Marriage & Family Therapist
- San Antonio, TX
- NPI 1538015862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775088000000",
"number": "1609451970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 AUSTIN ST UNIT 1442",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782081186",
"telephone_number": "954-801-6830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1203 AUSTIN ST UNIT 1442",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782081186",
"telephone_number": "954-801-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "CHRISTINA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-17",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "204266",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MO",
"license": "2025024980",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT4091",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NJ",
"license": "37FL00248400",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH19309",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "MFT.0002777",
"primary": false
}
],
"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 Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.