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

Mark Granda

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1366374563

Mark Granda is a Mental Health Counselor in San Antonio, Texas. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Texas.

Years since qualifying
1
Licensed in
TX
In the registry since
2026

Practice location Address checks out

12640 Corona Borealis
San Antonio, TX 78245-4861
Phone: (830) 225-1622
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 17557 (TX)

Record details

NPI number1366374563
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 1, 2026
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in San Antonio