Individual provider Active NPI

Mary R Duke, M.ED

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1629228622
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
268 Issued in HI
Practice address
19419 Bridge Oak
San Antonio, TX 78258-3638
Phone
(808) 214-3422
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 87048 TX
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 268 HI Primary

Addresses

Primary practice location

19419 Bridge Oak
San Antonio, TX 78258-3638

Mailing address

19419 Bridge Oak
San Antonio, TX 78258-3638
Phone (808) 214-3422

Other names 1

  • Mary R Atiburcio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
87048TXMDProfessional Counselor
268HIMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1629228622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19419 BRIDGE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583638",
            "telephone_number": "808-214-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19419 BRIDGE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583638",
            "telephone_number": "808-214-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "MARY",
        "middle_name": "R",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "87048",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ATIBURCIO",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 19, 2024; 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.