NPIMap

Organization Active NPI

Desta Therapy, LLC

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1891529673
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DESTA THERAPY, LLC
Practice address
16607 Blanco Rd Ste 12103
San Antonio, TX 78232-1961
Phone
(210) 417-9272
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
James Gross
Title
Co-Founder/Managing Partner
Phone
(210) 417-9272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

16607 Blanco Rd Ste 12103
San Antonio, TX 78232-1961

Mailing address

405 El Portal Dr
San Antonio, TX 78232-2003
Phone (210) 417-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250113000022 TX Part B Supplier - Clinic/Group Practice 8224566708 Receives reassigned benefits from 13 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

16607 Blanco Rd
Ste 12103
San Antonio, TX 78232
Phone (210) 417-7292

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1891529673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 EL PORTAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322003",
            "telephone_number": "210-417-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD STE 12103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321961",
            "telephone_number": "210-417-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTA THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CO-FOUNDER/MANAGING PARTNER",
        "authorized_official_telephone_number": "210-417-9272"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.