John Clay Self, L.P.C., L.C.D.C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

72206 Issued in TX

Practice address

743 County Road 6711
Natalia, TX 78059-2696

Phone

(210) 776-4028

NPI assigned

Sep 13, 2013

Last updated

Mar 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TX

  Medicare reassignment Care Compare group NPD
• Vcphcs VII, LLC

  dba Medmark Treatment Centers San Antonio Quincy

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Windcrest, TX
  • NPI 1992966584
  NPD (past)

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1891120440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 COUNTY ROAD 6711",
            "city": "NATALIA",
            "state": "TX",
            "postal_code": "780592696",
            "telephone_number": "210-776-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 COUNTY ROAD 6711",
            "city": "NATALIA",
            "state": "TX",
            "postal_code": "780592696",
            "telephone_number": "210-776-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "JOHN",
        "middle_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "L.P.C., L.C.D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "5623",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "72206",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalia Independent School Dist
• Natalia Isd
• Lorraine Emery Ortiz, L. P. C.
• Elsa Quinones
• Reagan Manor
• Samantha Shaffer
• Mayzabaan Umar, LVN
• Wenona Nephta-Li Wray, LPC, NCC

• Professional Counselor in Natalia, TX
• Providers in Natalia, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.