MEDICARE: YMCA OF GREATER SAN ANTONIO

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

General Provider Information

NPI Number	:	1396290458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YMCA OF GREATER SAN ANTONIO

Provider Business Mailing Address
First Line	:	5538 WALZEM RD., SUITE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-2103
Country	:	US
Telephone Number	:	210-796-3732
Fax Number	:	210-939-6369

Provider Business Practice Location Address
First Line	:	5538 WALZEM RD., SUITE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-2103
Country	:	US
Telephone Number	:	210-796-3732
Fax Number	:	210-939-6369

Authorized Official
Title or Position	:	DIRECTOR OF COUNSELING AND WELL-BEI
Name	:	MRS. KRISTINE MICHELLE GUSMAN
Credential	:	LPC-ASSOCIATE
Telephone Number	:	210-445-4937

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	06/01/2026

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Directions to “YMCA OF GREATER SAN ANTONIO ” Practice Location

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