MEDICARE: MR. BASHER M SALEM LPC,LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	61637	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	7782	TX
3	101YP2500X	Professional Counselor	61637	TX

General Provider Information

NPI Number	:	1275729782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BASHER M SALEM LPC,LCDC

Provider Business Mailing Address
First Line	:	8211 CREEKRUN VW
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3818
Country	:	US
Telephone Number	:	210-573-6954
Fax Number	:

Provider Business Practice Location Address
First Line	:	4242 E PIEDRAS DR STE 114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1430
Country	:	US
Telephone Number	:	210-393-9481
Fax Number	:	210-800-9916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	08/12/2025

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