Provider Demographics
NPI:1649616624
Name:BYNDOM, MARIA A (MS, LCPC, CCMHC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:BYNDOM
Suffix:
Gender:F
Credentials:MS, LCPC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20079 STONE OAK PKWY STE 1105-481
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-6942
Mailing Address - Country:US
Mailing Address - Phone:210-239-2190
Mailing Address - Fax:
Practice Address - Street 1:20079 STONE OAK PKWY STE 1105-481
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-6942
Practice Address - Country:US
Practice Address - Phone:210-864-6658
Practice Address - Fax:210-899-1952
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010448101YP2500X, 101Y00000X, 101YM0800X
TX82072101YP2500X, 101Y00000X, 101YM0800X
IL180.012153101YP2500X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health