Active NPI
Mary Margaret Caley-Bruce, MA, LPC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1861674608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61796
- Practice address
- 114 N. Ellison Dr.
Suite 416
San Antonio, TX 78251-5019 - Phone
- (210) 219-6163
- Fax
- (866) 223-7207
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 61796 | TX | Primary |
Addresses
Primary practice location
114 N. Ellison Dr.
Suite 416
San Antonio, TX 78251-5019
Mailing address
10730 Potranco Rd
Suite 122-264
San Antonio, TX 78251-3327
Phone (210) 219-6163
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1938821-01 | Medicaid | TX |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61796 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1861674608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10730 POTRANCO RD",
"address_2": "SUITE 122-264",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782513327",
"telephone_number": "210-219-6163",
"fax_number": "866-223-7207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 N. ELLISON DR.",
"address_2": "SUITE 416",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782515019",
"telephone_number": "210-219-6163",
"fax_number": "866-223-7207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALEY-BRUCE",
"first_name": "MARY",
"middle_name": "MARGARET",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "61796",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1938821-01",
"state": "TX"
}
],
"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 Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.