Active NPI
Joseph Robert Eatherly, LPC
- Professional Counselor
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 98464
- Practice address
- 540 Oak Centre Dr Ste 205
San Antonio, TX 78258-4767 - Phone
- (844) 824-8775
- NPI assigned
- Mar 30, 2010
- Last updated
- May 27, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Professional Counselor | 101YP2500X | 5004 | OK | |
| Professional Counselor | 101YP2500X | 98464 | TX | Primary |
Addresses
Primary practice location
540 Oak Centre Dr Ste 205
San Antonio, TX 78258-4767
Mailing address
49500 CR E 1600
Stratford, OK 74872
Phone (580) 320-5633
Other practice location 1
108 W Main St
Tishomingo, OK 73460-1723
Phone (580) 371-3019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
540 Oak Centre Dr
Suite 205
San Antonio, TX 78258-4767
Phone (844) 824-8775
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosaic Medbill LLC | Professional | Current | Accepting new patients |
| Emdr Solutions LLC | Current | Accepting new patients | |
| Progressive Behavioral Health, PLLC | Professional | Current | Accepting new patients |
| Mosaic Health Foundation | Past | Accepting new patients |
Locations
1013 15th Ave NW
Ardmore, OK 73401
Phone (580) 238-4277
5350 S Western Ave
Ste 215
Oklahoma City, OK 73109
Phone (405) 518-0082
308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386
12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078
23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500
540 Oak Centre Dr
Ste 205
San Antonio, TX 78258
Phone (210) 705-5001
Organizations & group practices 4
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.
-
dba LifeStance Health
- Mental Health Counselor
- Friendswood, TX
- NPI 1659567238
Professional
-
dba Mosaic Therapy
- Adult Mental Health Clinic/Center
- Oklahoma City, OK
- NPI 1255623930
Professional
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ardmore, OK
- NPI 1346935848
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Oklahoma City, OK
- NPI 1164203782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1720303134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49500 CR E 1600",
"city": "STRATFORD",
"state": "OK",
"postal_code": "74872",
"telephone_number": "580-320-5633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 OAK CENTRE DR STE 205",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782584767",
"telephone_number": "844-824-8775"
}
],
"practiceLocations": [
{
"address_1": "108 W Main St",
"address_purpose": "LOCATION",
"city": "Tishomingo",
"state": "OK",
"postal_code": "734601723",
"country_code": "US",
"telephone_number": "580-371-3019",
"fax_number": "580-371-0138",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EATHERLY",
"first_name": "JOSEPH",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-30",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "5004",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "98464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
- Paula Easton
- Margaret Liana Eastridge, MSN, AGCNS-BC, APRN
- Eastwood Realty Solutions, Inc (Eastwood Care Services)
- Levi Hunter Eastwood, LPC - ASSOCIATE
- Easy-Care Transit LLC
- Eating Recovery Center of Texas
- Bette J Eaton, LPC
- Carolyn Eaton, MD
- Catherine Torrington Eaton, PHD, CCC-SLP
- David S Eaton, LPC, LMHC, CCMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.