NPIMap

Organization Active NPI

The Ecumenical Center for Religion and Health

  • Counselor
  • San Antonio, TX
National Provider Identifier
1720147093
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
THE ECUMENICAL CENTER FOR RELIGION AND HEALTH
Practice address
8310 Ewing Halsell Drive
San Antonio, TX 78229-3715
Phone
(210) 616-0885
Fax
(210) 614-5633
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Ms. Mary Beth Fisk
Title
Ceo / Executive Director
Phone
(210) 616-0885

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

8310 Ewing Halsell Drive
San Antonio, TX 78229-3715

Mailing address

8310 Ewing Halsell Drive
San Antonio, TX 78229-3715
Phone (210) 616-0885

Other identifiers 2

IdentifierTypeStateIssuer
00N04FOtherBCBS
080417101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050719001210 TX Part B Supplier - Clinic/Group Practice 6204863491 Receives reassigned benefits from 5 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

8310 Ewing Halsell Dr
San Antonio, TX 78229
Phone (210) 616-0885

403 Avenue E
San Antonio, TX 78205
Phone (210) 226-7593

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1720147093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 EWING HALSELL DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293715",
            "telephone_number": "210-616-0885",
            "fax_number": "210-614-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 EWING HALSELL DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293715",
            "telephone_number": "210-616-0885",
            "fax_number": "210-614-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ECUMENICAL CENTER FOR RELIGION AND HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "FISK",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CEO / EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "210-616-0885",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00N04F",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080417101",
            "state": "TX"
        }
    ],
    "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 May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.