Individual provider Active NPI

Gloria L Ortiz, LPC

  • Mental Health Counselor
  • Crystal City, TX
National Provider Identifier
1609838069
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20004 Issued in TX
Practice address
203 N Avenue C
Crystal City, TX 78839-3550
Phone
(830) 374-9191
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 20004 TX
Mental Health Counselor 101YM0800X 20004 TX Primary

Addresses

Primary practice location

203 N Avenue C
Crystal City, TX 78839-3550

Mailing address

203 N Avenue C
Crystal City, TX 78839-3550
Phone (830) 374-9191

Other identifiers 2

IdentifierTypeStateIssuer
84860LOtherTXBLUE CROSS BLUE SHIELD
177998501MedicaidTX

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
I20240208001209 TX Practitioner - Mental Health Counselor 8527401371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20004TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Camino Real Community MHMR Center CurrentSince Feb 1, 2024 Accepting new patients
Lorenzo Ortiz Dba Wintergarden Counseling Services Professional Past Accepting new patients

Locations

1749 E State Highway 97
Jourdanton, TX 78026
Phone (830) 767-2320

19965 FM 3175
Lytle, TX 78052
Phone (210) 357-0300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1609838069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N AVENUE C",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393550",
            "telephone_number": "830-374-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N AVENUE C",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393550",
            "telephone_number": "830-374-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "GLORIA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "20004",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "20004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84860L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177998501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, TX

Sources for this page

Verify at the official NPI Registry.