NPIMap

Organization Active NPI

South Texas Liberty Alliance Group, Inc

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1679916829
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOUTH TEXAS LIBERTY ALLIANCE GROUP, INC
Practice address
11202 Disco
San Antonio, TX 78216-2860
Phone
(210) 495-2797
NPI assigned
Apr 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Authorized official

Name
Mrs. Brittany J Dodson, CRT
Title
Vice President
Phone
(210) 495-2797

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

11202 Disco
San Antonio, TX 78216-2860

Mailing address

11202 Disco
San Antonio, TX 78216-2860
Phone (210) 495-2797

National Provider Directory

National Provider Directory

Locations

11202 Disco
San Antonio, TX 78216
Phone (210) 495-2797

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1679916829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11202 DISCO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162860",
            "telephone_number": "210-495-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11202 DISCO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162860",
            "telephone_number": "210-495-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS LIBERTY ALLIANCE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "210-495-2797",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "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 Sep 19, 2017; 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.