Individual provider Active NPI

Nakaisha Tolbert-Banks, LCSW, LCAC

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1114356508
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006733A Issued in IN
Practice address
650 N Girls School Rd Ste C30
Indianapolis, IN 46214-3660
Phone
(323) 977-8570
Fax
(317) 245-4096
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87001534A IN
Clinical Social Worker 1041C0700X 34006733A IN Primary

Addresses

Primary practice location

650 N Girls School Rd Ste C30
Indianapolis, IN 46214-3660

Mailing address

650 N Girls School Rd Ste C30
Indianapolis, IN 46214-3660
Phone (323) 977-8570

Other practice location 1

777 Beachway Dr
Suite 100
Indianapolis, IN 46224-7700
Phone (765) 748-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
87001534AINMDAddiction (Substance Use Disorder) Counselor
34006733AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Duo Empowerment Services PastSince Feb 16, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1114356508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N GIRLS SCHOOL RD STE C30",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143660",
            "telephone_number": "323-977-8570",
            "fax_number": "317-245-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N GIRLS SCHOOL RD STE C30",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143660",
            "telephone_number": "323-977-8570",
            "fax_number": "317-245-4096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Beachway Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462247700",
            "country_code": "US",
            "telephone_number": "765-748-4096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLBERT-BANKS",
        "first_name": "NAKAISHA",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001534A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006733A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.