Address: 4243 E Piedras Dr Ste 226, San Antonio, TX 78228-1407

GLEN EDWARD TISDALE (NPI# 1851843437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851843437
Entity Type Individual
Gender Male
Credential LPC
Practice Address 4243 E Piedras Dr Ste 226
San Antonio
TX 78228-1407
Practice Telephone 2107095848
Mailing Address 4235 Valleyfield St
San Antonio
TX 78222-3714
Mailing Telephone 2107095848
Enumeration Date 2016-10-28
Last Update Date 2016-10-28
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 101Y00000X Counselor 73414 TX Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
73414 TX Behavioral Health & Social Service Providers
N 101YP2500X Counselor
Specialization: Professional
73414 TX Behavioral Health & Social Service Providers

Office Location

Street Address 4243 E PIEDRAS DR STE 226
State TX
Zip Code 78228-1407

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NPI Name Taxonomy Address Enumeration
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1386744332 Agnes L Palys Od PC · Vision Source Optometrist 4930 Evers Rd, San Antonio, TX 78228 2006-09-22
1912273590 Loma Park Assisted Living Inc Assisted Living Facility 1014 Nw 38th Street, San Antonio, TX 78228 2012-03-28
1902968092 Doris Ethyl Chase Marriage & Family Therapist 5805 Callaghan, Ste. 100, San Antonio, TX 78228 2006-12-14
1215487475 Compassus Op of Texas LLC · Compassus - San Antonio Hospice Care, Community Based 4242 E Piedras Dr, Suite 200, San Antonio, TX 78228 2016-10-11
1548827595 Paam Care, LLC. Assisted Living Facility 322 Early Trail, San Antonio, TX 78228 2019-05-24
1790889988 Catherine T Nguyen Dentist - General Practice 1618 Bandera Rd, San Antonio, TX 78228 2006-09-11
1760793814 Palliative Plus LLC · Paloma Hospice and Palliative Care Hospice Care, Community Based 4400 Piedras Dr, Suite 209, San Antonio, TX 78228 2010-06-23
1407220130 Jessica Marie Hernandez-Benavidez Counselor - Professional 2939 W. Woodlawn, Buidling 2, San Antonio, TX 78228 2015-11-18
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1386225829 Alyssa Arredondo Counselor 2703 Montebello, San Antonio, TX 78259-2160 2021-04-16
1275111221 Diane Elizabeth Cisneros Counselor 2121 Lockhill Selma Rd, San Antonio, TX 78213-1410 2021-03-31
1316523749 Mandy Renee-Marin Randall · Mandy Renee Marin Counselor 3803 Lenten Rose, San Antonio, TX 78259-2348 2021-03-24
1386238673 Merrik Laine Hetherington Counselor 7822 Bantry Ct, San Antonio, TX 78240-5722 2021-02-26
1588258461 Mending Hearts LLC Counselor 5886 De Zavala Rd, Suite 102 #453, San Antonio, TX 78249-2269 2021-02-22
1205428794 Waterman Counseling LLC Counselor 7567 Corian Park Dr, San Antonio, TX 78249-3627 2021-02-07
1821689076 Arianna Skinner-Beck Counselor 6766 Manor Hill, San Antonio, TX 78257 2021-01-31
1699366096 Robert Charles Stead Counselor 6963 Sunset Village Dr, San Antonio, TX 78249-3511 2021-01-28
1023605359 Goldicare Medical, Pllc Counselor 36 Chapel Hill Cir, San Antonio, TX 78240-3903 2020-12-21
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Zip Code 78228

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Dataset Information

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.