Active NPI
Marcella Eloise Quesada, LPC
- Mental Health Counselor
- San Antonio, TX
National Provider Identifier
1891824843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 68268
- Practice address
- 4940 Broadway Street
Suite 112
San Antonio, TX 78209-5732 - Phone
- (904) 894-6623
- Fax
- (210) 468-6203
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 68268 | TX | Primary |
Addresses
Primary practice location
4940 Broadway Street
Suite 112
San Antonio, TX 78209-5732
Mailing address
4940 Broadway Street
Suite 112
San Antonio, TX 78209-5732
Phone (904) 894-6623
Other names 1
- Miss Marcella Eloise Lopez
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68268 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1891824843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4940 BROADWAY STREET",
"address_2": "SUITE 112",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782095732",
"telephone_number": "904-894-6623",
"fax_number": "210-468-6203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4940 BROADWAY STREET",
"address_2": "SUITE 112",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782095732",
"telephone_number": "904-894-6623",
"fax_number": "210-468-6203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUESADA",
"first_name": "MARCELLA",
"middle_name": "ELOISE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "68268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARCELLA",
"last_name": "LOPEZ",
"middle_name": "ELOISE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}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 Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.