Active NPI
Kristi Breton, LICSW
- Clinical Social Worker
- Jbsa Lackland, TX
National Provider Identifier
1720955172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 117454
- Practice address
- 1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 292-6255
- Fax
- (210) 292-7934
- NPI assigned
- Oct 21, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW026715 | PA | |
| Clinical Social Worker | 1041C0700X | LW70004522 | WA | |
| Clinical Social Worker | 1041C0700X | 117454 | TX | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Mailing address
113551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 292-6255
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
| License | State | Type | Specialty |
|---|---|---|---|
| CW026715 | PA | MD | Clinical Social Worker |
| LW70004522 | WA | MD | Clinical Social Worker |
| 117454 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whasc | Clinical | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Social Worker
- Lackland Afb, TX
- NPI 1225846116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1720955172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-292-6255",
"fax_number": "210-292-7934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG 4554",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-6255",
"fax_number": "210-292-7934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRETON",
"first_name": "KRISTI",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-21",
"last_updated": "2026-09-09",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW026715",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW70004522",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "117454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.