Provider Demographics
NPI:1194001131
Name:SOUTH TEXAS PSYCHOTHERAPY
Entity Type:Organization
Organization Name:SOUTH TEXAS PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SHULTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-822-2600
Mailing Address - Street 1:900 NE LOOP 410
Mailing Address - Street 2:SUITE D-101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1410
Mailing Address - Country:US
Mailing Address - Phone:210-822-2600
Mailing Address - Fax:210-822-2685
Practice Address - Street 1:900 NE LOOP 410
Practice Address - Street 2:SUITE D-101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1410
Practice Address - Country:US
Practice Address - Phone:210-822-2600
Practice Address - Fax:210-822-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No102X00000XBehavioral Health & Social Service ProvidersPoetry TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty