Jacob Lara, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

83786 Issued in TX

Practice address

6333 De Zavala Rd Ste A241
San Antonio, TX 78249-2115

Phone

(210) 866-3860

NPI assigned

Oct 25, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Jewish Family Service of San Antonio Texas Inc.

  • Mental Health Counselor
  • San Antonio, TX
  • NPI 1679606701

  Professional

  NPD
• Carol Albert

  • Community/Behavioral Health Agency
  • San Antonio, TX
  • NPI 1538238662
  NPD (past)

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1891459905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 DE ZAVALA RD STE A241",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492115",
            "telephone_number": "210-866-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 DE ZAVALA RD STE A241",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492115",
            "telephone_number": "210-866-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "JACOB",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0854226-02",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jfs-sa.org",
            "affiliation": "N",
            "address_1": "12500 NW Military Hwy Ste 250",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782312000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana H Lara, LPC
• Domingo A Lara, MD
• Elizabeth Angie Lara, RRT
• Ethsel Lara, QMHP-CS
• Frankie Aaron Lara, LPC
• Javier Lara
• Joycette Lara
• Juan Lara
• Leslie Natalie Lara, LPC
• Mabel Denise Lara, COTA

• 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 Sep 12, 2023; 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.