Individual provider Active NPI

Marisa Ybarra, LPC

  • Professional Counselor
  • Cedar Park, TX
National Provider Identifier
1760958581
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74105 Issued in TX
Practice address
345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484
Phone
(512) 842-5168
Fax
(512) 727-0476
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 74105 TX Primary

Addresses

Primary practice location

345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484

Mailing address

PO Box 660253
Austin, TX 78766-7253
Phone (512) 842-5168

Other names 1

  • Marisa Nagle Former name

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
I20240215001998 TX Practitioner - Mental Health Counselor 3577907765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74105TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Feb 1, 2024 Accepting new patients
Roberson Counseling Center, PLLC Professional PastSince Feb 7, 2018 Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 2

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1760958581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660253",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787667253",
            "telephone_number": "512-842-5168",
            "fax_number": "512-727-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CYPRESS CREEK RD STE 102",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134484",
            "telephone_number": "512-842-5168",
            "fax_number": "512-727-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YBARRA",
        "first_name": "MARISA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "NAGLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.