Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Life Fulfillment and Wellness LLC

Organization Mental Health Counselor · NPI 1619540077

Life Fulfillment and Wellness LLC is a Mental Health Counselor in San Antonio, Texas. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4335 W Piedras Dr Ste 103
San Antonio, TX 78228-1215
Phone: (210) 600-4117
Fax: (210) 600-3849
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1619540077
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Imelda Reveron — Ceo/Administrator · (210) 600-4117
NPI enumeratedJuly 22, 2021
Last updated in NPPESJuly 22, 2021
Certification dateJuly 22, 2021
Mailing address21916 Park View Dr, Garden Ridge, TX 78266-2749

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