NPIMap

Organization Active NPI

Our Lady of the Lake University

Doing business as Community Counseling Service

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1780769265
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16408 Issued in TX
Legal business name
OUR LADY OF THE LAKE UNIVERSITY
Doing business as
Community Counseling Service
Practice address
590 North General McMullen
3
San Antonio, TX 78228
Phone
(210) 434-1054
Fax
(210) 434-1380
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mrs. Bernadette Solorzano, PSYDNPI 1841335247
Title
Clinic Director
Phone
(210) 434-1054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 16408 TX Primary

Addresses

Primary practice location

590 North General McMullen
3
San Antonio, TX 78228

Mailing address

590 North General McMullen
3
San Antonio, TX 78228
Phone (210) 434-1054

Other identifiers 1

IdentifierTypeStateIssuer
1446742MedicaidTX

Other names 1

  • Community Counseling Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of the Lake University San Antonio5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1780769265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 NORTH GENERAL MCMULLEN",
            "address_2": "3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78228",
            "telephone_number": "210-434-1054",
            "fax_number": "210-434-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 NORTH GENERAL MCMULLEN",
            "address_2": "3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78228",
            "telephone_number": "210-434-1054",
            "fax_number": "210-434-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE LAKE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "SOLORZANO",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "210-434-1054",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "16408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1446742",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.