Provider Demographics
NPI:1205471828
Name:CHRISELDA SANTOS THERAPY INCORPORATED
Entity type:Organization
Organization Name:CHRISELDA SANTOS THERAPY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-549-6663
Mailing Address - Street 1:31910 OAK RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-3042
Mailing Address - Country:US
Mailing Address - Phone:210-549-6663
Mailing Address - Fax:210-610-8291
Practice Address - Street 1:8627 CINNAMON CREEK DR BLDG 401
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1482
Practice Address - Country:US
Practice Address - Phone:210-549-6663
Practice Address - Fax:210-610-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316840305Medicaid