MR. NICKOLAS SCOTT RACZEK LPC
NPI 1053917377
Counselor - Professional in San Antonio, TX

Q: What is Nickolas Raczek's NPI number?

The NPI number for Nickolas Raczek is 1053917377. It was assigned to this individual provider in the NPPES registry on December 10, 2020.

Q: What is Nickolas Raczek's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Nickolas Raczek was last updated on November 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 10, 2020PECOS Enrolled

6812 BANDERA RD STE 102, SAN ANTONIO, TX 78238(210) 261-3350(210) 261-1794 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 15, 2023, Feb 16, 2023, Dec 10, 2020 (3 updates tracked since 2020).

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About Mr. Nickolas Scott Raczek Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. NICKOLAS SCOTT RACZEK LPC (NPI 1053917377) is an individual professional provider in San Antonio, Texas, licensed in Texas (82015) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053917377

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. NICKOLAS SCOTT RACZEKCredential: LPC

Location Address6812 BANDERA RD STE 102San Antonio, TX 78238-1378

Mailing Address6800 Park Ten Blvd Ste 200sSan Antonio, TX 78213-4293 · (210) 261-1060 · Fax (210) 261-1821

Phone(210) 261-3350

Fax(210) 261-1794

Sole ProprietorNo

Enumeration DateDecember 10, 2020

Last NPPES UpdateNovember 15, 20233 updates tracked since enumeration

NPPES CertifiedNovember 15, 2023

✔ NPI 1053917377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in TX · 82015

6812 BANDERA RD STE 102, San Antonio, TX 78238

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Cigna Healthcare, Community First.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Nickolas Scott Raczek Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nickolas Raczek reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bexar County Board Of Trustees For Mental Health Mental Retardation

4.7 mi

Family Medicine

6800 PARK TEN BLVD, SUITE 200-S
San Antonio, TX 78213

Reassigned Medicare billing, Texas enrollment
210 clinicians in this Medicare group

NPI 1679948392 (210) 261-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATHAN YEE MD

Psychiatry & Neurology (Psychiatry)