Individual provider Active NPI

Shaneka Calloway, LPC

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1720418239
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
65303 Issued in TX
Practice address
702 San Pedro Ave
San Antonio, TX 78212-4610
Phone
(210) 299-2400
Fax
(210) 270-0545
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 65303 TX
Mental Health Counselor 101YM0800X 65303 TX Primary

Addresses

Primary practice location

702 San Pedro Ave
San Antonio, TX 78212-4610

Mailing address

702 San Pedro Ave
San Antonio, TX 78212-4610
Phone (210) 299-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419000849 TX Practitioner - Mental Health Counselor 9931548237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

2622 E Commerce St
San Antonio, TX 78203-2102
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA Mental Health CurrentSince Jul 1, 2024 Accepting new patients
Vcounselors PLLC Professional CurrentSince Mar 17, 2024 Accepting new patients
Family Service Association of San Antonio, Inc. Professional PastSince Nov 6, 2019 Accepting new patients

Locations

5522 Lone Star Pkwy
Ste 303
San Antonio, TX 78253
Phone (210) 614-4990

Interoperability endpoints

  • Direct secure messaging: shaneka.calloway.1@23300.direct.athenahealth.com

Organizations & group practices 3

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1720418239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124610",
            "telephone_number": "210-299-2400",
            "fax_number": "210-270-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124610",
            "telephone_number": "210-299-2400",
            "fax_number": "210-270-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "SHANEKA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65303",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "65303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.