Healthcare Provider Details

I. General information

NPI: 1053346346
Provider Name (Legal Business Name): JOHN G DIMLER LPC, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4204 GARDENDALE ST STE 203
SAN ANTONIO TX
78229-3132
US

IV. Provider business mailing address

4204 GARDENDALE ST STE 203
SAN ANTONIO TX
78229-3132
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-8452
  • Fax: 210-614-8561
Mailing address:
  • Phone: 210-614-8452
  • Fax: 210-614-8561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14338
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number21650
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: