Individual provider Active NPI

Marivel M Hinojosa, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Crystal City, TX
National Provider Identifier
1851864078
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12886 Issued in TX
Practice address
308 S Cesar Chavez Ave
Crystal City, TX 78839-4200
Phone
(830) 374-2872
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12886 TX Primary

Addresses

Primary practice location

308 S Cesar Chavez Ave
Crystal City, TX 78839-4200

Mailing address

717 E Bexar St
Crystal City, TX 78839-2314
Phone (830) 279-9689

Other identifiers 1

IdentifierTypeStateIssuer
1770511032MedicaidTX

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

LicenseStateTypeSpecialty
12886TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1851864078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E BEXAR ST",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788392314",
            "telephone_number": "830-279-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S CESAR CHAVEZ AVE",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788394200",
            "telephone_number": "830-374-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINOJOSA",
        "first_name": "MARIVEL",
        "middle_name": "M",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770511032",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.