Individual provider Active NPI

Janna Wallace-Lennox, LMFT

  • Marriage & Family Therapist
  • San Antonio, TX
National Provider Identifier
1821663048
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12844 Issued in TX
Practice address
4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312
Phone
(210) 564-9116
Fax
(210) 564-9087
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12844 TX Primary

Addresses

Primary practice location

4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312

Mailing address

100 Ellis Pond CT
Weatherford, TX 76085-1650
Phone (661) 860-2189

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
I20240115001644 TX Practitioner - Marriage and Family Therapist 4082066162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12844TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Sight LLC CurrentSince Jan 5, 2024 Accepting new patients

Locations

14310 Northbrook Dr
Ste 260
San Antonio, TX 78232
Phone (210) 564-9116

17503 La Cantera Pkwy
#104293
San Antonio, TX 78257
Phone (210) 564-9116

4203 Woodcock Dr
Ste 216
San Antonio, TX 78228
Phone (210) 564-9116

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1821663048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELLIS POND CT",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760851650",
            "telephone_number": "661-860-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR STE 216",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-564-9116",
            "fax_number": "210-564-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE-LENNOX",
        "first_name": "JANNA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "12844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.