MR. JEREMY DAVID FACKELMAN MS STUDENT COUNSELOR
NPI 1205463924
Student in an Organized Health Care Education/Training Program in San Antonio, TX

Q: What is Jeremy Fackelman's NPI number?

The NPI number for Jeremy Fackelman is 1205463924. It was assigned to this individual provider in the NPPES registry on March 24, 2020.

Q: What is Jeremy Fackelman's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Fackelman was last updated on March 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 March 24, 2020

7400 BLANCO RD STE 250, SAN ANTONIO, TX 78216(210) 446-8255(210) 437-4774 Get Directions Write a Review

NPPES record last updated: March 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mr. Jeremy David Fackelman Ms Student Counselor NPPES

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

MR. JEREMY DAVID FACKELMAN MS STUDENT COUNSELOR (NPI 1205463924) is an individual student in an organized health care education/training program in San Antonio, Texas and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1205463924

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. JEREMY DAVID FACKELMANCredential: MS STUDENT COUNSELOR

Location Address7400 BLANCO RD STE 250San Antonio, TX 78216-4368

Mailing Address7400 Blanco Rd Ste 250San Antonio, TX 78216-4368 · (210) 446-8255 · Fax (210) 437-4774

Phone(210) 446-8255

Fax(210) 437-4774

Sole ProprietorYes

Enumeration DateMarch 24, 2020

NPPES CertifiedMarch 24, 2020

✔ NPI 1205463924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

7400 BLANCO RD STE 250, San Antonio, TX 78216

Open in Google Maps ↗

Other Providers at the Same Location NPPES 11

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

DEEP DIVE INDIVIDUAL AND FAMILY COUNSELING SERVICES PLLC

Counselor (Mental Health)