Susanna Kitayama, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

203028 Issued in TX

Practice address

21015 Market RDG
San Antonio, TX 78258-4975

Phone

(210) 469-0100

NPI assigned

Feb 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not 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.

• Melissa McVicker PHD LMFT PLLC

  • Marriage & Family Therapist
  • San Antonio, TX
  • NPI 1689268161
  NPD

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1912603689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21015 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584975",
            "telephone_number": "210-469-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21015 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584975",
            "telephone_number": "210-469-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITAYAMA",
        "first_name": "SUSANNA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Patrick Kissel, D.P.M.
• Emily Dawn Kissling, BCBA
• Natalie Nikeisha Kissoon, MD
• Kenneth Kist, MD
• Annaliese Elaine Kistler, M.D.
• Jessica Ashley Kitchen, MD
• Tracy Lynn Kitchen, LCSW
• Tiffany Wray Kitchens, MSN, FNP-C
• Irene Kitson, COTA
• Delease Shawn Kittell Green, LCSW

• Marriage & Family Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.