Healthcare Provider Details

I. General information

NPI: 1598656795
Provider Name (Legal Business Name): CONTRERAS COUNSELING & CHRONIC PAIN SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 CALLAGHAN RD STE 305
SAN ANTONIO TX
78228-1132
US

IV. Provider business mailing address

12127 FAITHCREST
SAN ANTONIO TX
78253-5498
US

V. Phone/Fax

Practice location:
  • Phone: 210-570-0818
  • Fax:
Mailing address:
  • Phone: 210-264-6079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. JACQUELINE CONTRERAS
Title or Position: CEO/PSYCHOTHERAPIST
Credential: PH.D., LPC
Phone: 210-264-6079