Individual provider Active NPI

Kelly S Zentner, LPC-S

  • Counselor
  • Garden Ridge, TX
National Provider Identifier
1659316537
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
17764 Issued in TX
Practice address
19115 FM 2252 Ste 15
Garden Ridge, TX 78266
Phone
(210) 833-1900
Fax
(210) 281-5108
NPI assigned
Jun 17, 2006
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 17764 TX Primary
Mental Health Counselor 101YM0800X 17764 TX

Addresses

Primary practice location

19115 FM 2252 Ste 15
Garden Ridge, TX 78266

Mailing address

19115 FM 2252 Ste 15
Garden Ridge, TX 78266
Phone (210) 833-1900

Other identifiers 2

IdentifierTypeStateIssuer
152081901MedicaidTX
0017LKOtherTXBCBS NUMBER

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
17764TXMDSpeech-Language Pathologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1659316537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 FM 2252 STE 15",
            "city": "GARDEN RIDGE",
            "state": "TX",
            "postal_code": "78266",
            "telephone_number": "210-833-1900",
            "fax_number": "210-281-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 FM 2252 STE 15",
            "city": "GARDEN RIDGE",
            "state": "TX",
            "postal_code": "78266",
            "telephone_number": "210-833-1900",
            "fax_number": "210-281-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENTNER",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "17764",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152081901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "0017LK",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Ridge, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.