Lone Star Revelation LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LONE STAR REVELATION LLC

Doing business as

Revelation Counseling Services

Practice address

1811 S Laredo St Ste 111
San Antonio, TX 78207-7019

Phone

(210) 744-4828

Fax

(210) 229-8973

NPI assigned

Jan 26, 2024

Last updated

Feb 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline A. Hernandez, LPC-SNPI 1407370612

Title

Founder/Ceo

Phone

(210) 324-0658

Specialties & licenses 15

Addresses

Other names 1

• Revelation Counseling Services Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline A Hernandez, LPC-S

  • Mental Health Counselor
  • San Antonio, TX
  • NPI 1407370612
  NPD Authorized official

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1871355636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 S LAREDO ST STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077019",
            "telephone_number": "210-324-0658",
            "fax_number": "210-229-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 S LAREDO ST STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077019",
            "telephone_number": "210-744-4828",
            "fax_number": "210-229-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR REVELATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "210-324-0658",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revelation Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revelation Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.