OUR LADY OF THE LAKE UNIVERSITY (NPI# 1588823199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588823199 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF THE LAKE UNIVERSITY |
| Other Organization Name | COMMUNITY COUNSELING SERVICE |
| Practice Address |
590 N General Mcmullen 3 San Antonio TX 78228-6205 |
| Practice Telephone | 2104341054 |
| Practice Fax Number | 2104341380 |
| Mailing Telephone | 2104341054 |
| Mailing Fax Number | 2104341380 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |
| Authorized Official Name | MRS. BERNADETTE H SOLORZANO (CLINIC DIRECTOR) |
| Authorized Official Telephone | 2104341054 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
62520 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 144674201 | 05 |
| Other Name | Type Code |
|---|---|
| Community Counseling Service | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982753448 | Our Lady of The Lake University | Clinic/Center | 590 N General Mcmullen Dr, 3, San Antonio, TX 78228-6205 | 2007-01-10 |
| 1780769265 | Our Lady of The Lake University | Counselor | 590 North General Mcmullen, 3, San Antonio, TX 78228 | 2006-10-25 |
| 1689811374 | Our Lady of The Lake University | Psychologist | 590 N General Mcmullen, 3, San Antonio, TX 78228-6205 | 2009-01-16 |
| 1063622314 | Our Lady of The Lake University | Speech-Language Pathologist | 411 Sw 24th St, San Antonio, TX 78207-4617 | 2007-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OUR LADY OF THE LAKE UNIVERSITY OF SAN ANTONIO | 411 Sw 24th St, San Antonio, TX 78207-4617 |
| Street Address |
590 N GENERAL MCMULLEN 3 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78228-6205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689674509 | Michael Joseph Dominguez | Family Medicine | 590 N General Mcmullen, Suite 1, San Antonio, TX 78228-6205 | 2005-07-22 |
| 1689811374 | Our Lady of The Lake University | Psychologist | 590 N General Mcmullen, 3, San Antonio, TX 78228-6205 | 2009-01-16 |
| 1396914446 | Holy Cross Center Family | Legal Medicine | 590 N General Mcmullen, Suite 1, San Antonio, TX 78228-6205 | 2008-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770064206 | Isabel Cristina Moreno | Licensed Vocational Nurse | 5419 Shivalik Way, San Antonio, TX 78228 | 2018-08-23 |
| 1053846097 | Miguel Angel Hernandez | Counselor | 3615 Culebra Road, San Antonio, TX 78228 | 2017-04-27 |
| 1841724424 | Amber Fragoso | Specialist/Technologist | 1 Camino Sanata Maria, San Antonio, TX 78228 | 2017-04-20 |
| 1184175937 | John Amundson IIi | Counselor | 4243 E Piedras Dr # 100, San Antonio, TX 78228 | 2016-10-17 |
| 1215487475 | Compassus Op of Texas LLC | Hospice Care, Community Based | 4242 E Piedras Dr, Suite 200, San Antonio, TX 78228 | 2016-10-11 |
| 1407220130 | Jessica Marie Hernandez-benavidez | Counselor | 2939 W. Woodlawn, Buidling 2, San Antonio, TX 78228 | 2015-11-18 |
| 1720494214 | Early Trail Inc | Assisted Living Facility | 322 Early Trail, San Antonio, TX 78228 | 2014-07-07 |
| 1992117717 | R A Alvarado Medical Pllc | Pain Medicine | 4100 E Piedras Dr Ste 165, San Antonio, TX 78228 | 2014-05-28 |
| 1447681606 | Smile Kings Bandera, Pllc | Dentist | 919 Bandera Rd. Ste 101, San Antonio, TX 78228 | 2013-12-12 |
| 1811230345 | Gwendolyn Holland | Registered Nurse | 5310 Arrowhead Dr, San Antonio, TX 78228 | 2013-04-03 |
| Find all providers in zip 78228 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738311 | Jade Hodges | Counselor | 1402 Brook Run, San Antonio, TX 78232-5133 | 2020-10-20 |
| 1821696063 | Brent Crowson | Counselor | 23602 Enchanted Path, San Antonio, TX 78260-4323 | 2020-10-10 |
| 1730787961 | Alexander W Casserly | Counselor | 3442 Wellsprings Dr, San Antonio, TX 78230-2512 | 2020-10-09 |
| 1578170270 | Magno Solutions LLC | Counselor | 10422 Castello Cyn, San Antonio, TX 78254-4644 | 2020-09-26 |
| 1073120184 | Stacie Dziuk | Counselor | 12139 Bowie Ml, San Antonio, TX 78253-5879 | 2020-09-23 |
| 1508471293 | Sandra Jean Bar-yadin | Counselor | 12000 Network Blvd Ste 300, San Antonio, TX 78249-3344 | 2020-09-10 |
| 1316551039 | Mateo David Ayala, Texas Counseling | Counselor | 9818 Village Briar, San Antonio, TX 78250-5718 | 2020-09-01 |
| 1841801412 | Ijeoma Chinwe Too-chiobi | Counselor | 11467 Huebner Rd, San Antonio, TX 78230-1595 | 2020-08-16 |
| 1851901516 | Kenny Garza | Counselor | 5000 Walzem Rd, San Antonio, TX 78218 | 2020-08-06 |
| 1851900468 | Vanessa Montemayor Perez | Counselor | 330 Pennystone Ave, San Antonio, TX 78223-1825 | 2020-07-29 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78228 |
Please comment or provide details below to improve the information on OUR LADY OF THE LAKE UNIVERSITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.