Individual provider Active NPI

Edward Joseph Ingle

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1780058701
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
70305 Issued in TX
Practice address
8207 Callaghan Rd Ste 425
San Antonio, TX 78230-4737
Phone
(210) 366-3700
Fax
(210) 265-1442
NPI assigned
Nov 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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 70305 TX Primary

Addresses

Primary practice location

8207 Callaghan Rd Ste 425
San Antonio, TX 78230-4737

Mailing address

8207 Callaghan Rd Ste 425
San Antonio, TX 78230-4737
Phone (210) 366-3700

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
I20240117002271 TX Practitioner - Mental Health Counselor 9830541622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70305TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Layne Counseling, PLLC Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

8637 Fredericksburg Rd
Ste 149
San Antonio, TX 78240
Phone (210) 828-3737

3740 Colony Dr
Ste 122
San Antonio, TX 78230
Phone (210) 733-9929

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.

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1780058701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8207 CALLAGHAN RD STE 425",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304737",
            "telephone_number": "210-366-3700",
            "fax_number": "210-265-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 CALLAGHAN RD STE 425",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304737",
            "telephone_number": "210-366-3700",
            "fax_number": "210-265-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGLE",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.