Justina Ozuna Heredia, LCDC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

78092 Issued in TX

Practice address

3425 YMCA Dr Apt 60
San Angelo, TX 76904-7180

Phone

(210) 288-0567

NPI assigned

Nov 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Justine Antoinette Ozuna Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: justinaheredia@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Professional

  NPD

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1801430822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 YMCA DR APT 60",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047180",
            "telephone_number": "210-288-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 YMCA DR APT 60",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047180",
            "telephone_number": "210-288-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "JUSTINA",
        "middle_name": "OZUNA",
        "name_prefix": "Mrs.",
        "credential": "LCDC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78092",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12620",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "OZUNA",
            "middle_name": "ANTOINETTE",
            "prefix": "MISS",
            "credential": "LCDC, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Elisabeth Henson, DDS
• David Charles Herbert, M.D.
• James Waldo Herbert, M. D.
• Lauren Herbert, LPC-A
• Garrett Herdman, PA-C
• Adriana Hernandez, RBT
• Brandan Hernandez, M.D.
• Hunter Hernandez
• Jonathan David Hernandez, DDS
• Darrell T Herrington, DO

• Professional Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.