Individual provider Active NPI

Stephanie E Peterson, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1871730002
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
20300 Issued in TX
Practice address
7404 Hwy 90 W
Building#7
San Antonio, TX 78227-4024
Phone
(210) 832-5000
Fax
(210) 832-5005
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 20300 TX Primary

Addresses

Primary practice location

7404 Hwy 90 W
Building#7
San Antonio, TX 78227-4024

Mailing address

909 NE Loop 410 Ste 800
Attn: Jackie Grayson
San Antonio, TX 78209-1311
Phone (210) 832-5000

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
20300TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1871730002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 NE LOOP 410 STE 800",
            "address_2": "ATTN: JACKIE GRAYSON",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091311",
            "telephone_number": "210-832-5000",
            "fax_number": "210-832-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7404 HWY 90 W",
            "address_2": "BUILDING#7",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782274024",
            "telephone_number": "210-832-5000",
            "fax_number": "210-832-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "20300",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 9, 2009; 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.