Individual provider Active NPI

Dinara Blomberg

  • Professional Counselor
  • West Lake Hills, TX
National Provider Identifier
1659199768
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
96544 Issued in TX
Practice address
4407 Bee Caves Rd Ste 422
West Lake Hills, TX 78746-6406
Phone
(512) 469-0535
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 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 96544 TX Primary

Addresses

Primary practice location

4407 Bee Caves Rd Ste 422
West Lake Hills, TX 78746-6406

Mailing address

3805 Hillbrook Dr
Austin, TX 78731-4063

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

State licenses

LicenseStateTypeSpecialty
96544TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Wellness CurrentSince Sep 29, 2024 Accepting new patients
Ethos Prism, LLC PastSince Sep 29, 2024 Accepting new patients

Locations

4407 Bee Caves Rd
Ste 422
West Lake Hills, TX 78746
Phone (512) 469-0535

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": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1659199768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 HILLBROOK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 BEE CAVES RD STE 422",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466406",
            "telephone_number": "512-469-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMBERG",
        "first_name": "DINARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "96544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.