Provider Demographics
NPI:1972046514
Name:HIPSHER, MYSTRI LEA (MA, LPC, LPCC)
Entity Type:Individual
Prefix:
First Name:MYSTRI
Middle Name:LEA
Last Name:HIPSHER
Suffix:
Gender:F
Credentials:MA, LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 E PIEDRAS DR BLDG SUITE100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1421
Mailing Address - Country:US
Mailing Address - Phone:210-733-7118
Mailing Address - Fax:210-775-6601
Practice Address - Street 1:4243 E PIEDRAS DR BLDG SUITE100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1421
Practice Address - Country:US
Practice Address - Phone:210-733-7118
Practice Address - Fax:210-775-6601
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75558390200000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program