Active NPI
Kelly Anderson, LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1790486595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 77103
- Practice address
- 19115 FM 2252 Ste 12
San Antonio, TX 78266-2578 - Phone
- (210) 951-0049
- NPI assigned
- Mar 17, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 77103 | TX | Primary |
Addresses
Primary practice location
19115 FM 2252 Ste 12
San Antonio, TX 78266-2578
Mailing address
19115 FM 2252 Ste 12
San Antonio, TX 78266-2578
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 |
|---|---|---|---|
| 77103 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1790486595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19115 FM 2252 STE 12",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782662578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19115 FM 2252 STE 12",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782662578",
"telephone_number": "210-951-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KELLY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "77103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.