Organization Active NPI

Pariah Ventures Group LLC

  • Case Manager/Care Coordinator
  • Bastrop, TX
National Provider Identifier
1023972270
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
PARIAH VENTURES GROUP LLC
Practice address
702 W State Highway 71 # 1015
Bastrop, TX 78602-4029
Phone
(979) 505-9174
Fax
(855) 945-3878
NPI assigned
Dec 12, 2025
Last updated
Dec 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lakeisha Yvette Moore, LCSW
Title
Licensed Clinical Social Worker
Phone
(979) 661-1213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

702 W State Highway 71 # 1015
Bastrop, TX 78602-4029

Mailing address

702 W State Highway 71 # 1015
Bastrop, TX 78602-4029
Phone (979) 505-9174

National Provider Directory

National Provider Directory

Locations

702 W State Highway 71
#1015
Bastrop, TX 78602
Phone (979) 505-9174

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1023972270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W STATE HIGHWAY 71 # 1015",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024029",
            "telephone_number": "979-505-9174",
            "fax_number": "855-945-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W STATE HIGHWAY 71 # 1015",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024029",
            "telephone_number": "979-505-9174",
            "fax_number": "855-945-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARIAH VENTURES GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LAKEISHA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "979-661-1213",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.