Individual provider Active NPI

Jason Northrup, PH.D., LMFT-S

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1952557787
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
200911 Issued in TX
Practice address
21015 Market Ridge
Ste. 101
San Antonio, TX 78258-4979
Phone
(210) 496-0100
Fax
(210) 496-0101
NPI assigned
Aug 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 62058 TX
Marriage & Family Therapist 106H00000X 200911 TX
Mental Health Counselor 101YM0800X 200911 TX Primary

Addresses

Primary practice location

21015 Market Ridge
Ste. 101
San Antonio, TX 78258-4979

Mailing address

21015 Market Ridge
Ste. 101
San Antonio, TX 78258-4979
Phone (210) 833-4011

Medicare participation

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
62058TXMDProfessional Counselor
200911TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northrup Therapy Mental Health CurrentSince Sep 5, 2021 Accepting new patients
Lindsay Durham Ma LMFT PLLC CurrentSince Sep 5, 2021 Accepting new patients
Teo Therapy Services Mental Health PastSince Oct 30, 2022 Accepting new patients
Melissa McVicker PHD LMFT PLLC Marriage & Family Therapist PastSince Mar 4, 2021 Accepting new patients

Locations

21015 Market Rdg
Ste 101
San Antonio, TX 78258
Phone (210) 496-0100

500 N Loop 1604 E
Ste 220
San Antonio, TX 78232
Phone (210) 461-2214

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1952557787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21015 MARKET RIDGE",
            "address_2": "STE. 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584979",
            "telephone_number": "210-833-4011",
            "fax_number": "210-496-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21015 MARKET RIDGE",
            "address_2": "STE. 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584979",
            "telephone_number": "210-496-0100",
            "fax_number": "210-496-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "JASON",
        "credential": "PH.D., LMFT-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62058",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "200911",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "200911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.