Individual provider Active NPI

Brandy N Avila, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1124722038
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65124 Issued in TX
Practice address
4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312
Phone
(210) 564-9116
Fax
(210) 564-9087
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 65124 TX Primary

Addresses

Primary practice location

4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312

Mailing address

4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312
Phone (210) 564-9116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230331000557 TX Practitioner - Clinical Social Worker 6507231727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mind Sight LLCGroup PAC ID 0648585067, 7 clinicians

Practice addresses (Care Compare)

14310 Northbrook Dr
Suite 260
San Antonio, TX 78232-5051
Phone (210) 564-9116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Sight LLC Clinical CurrentSince Mar 16, 2023 Accepting new patients

Locations

17503 La Cantera Pkwy
#104293
San Antonio, TX 78257
Phone (210) 564-9116

4203 Woodcock Dr
Ste 216
San Antonio, TX 78228
Phone (210) 564-9116

14310 Northbrook Dr
Ste 260
San Antonio, TX 78232
Phone (210) 564-9116

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1124722038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR STE 216",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-564-9116",
            "fax_number": "210-564-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR STE 216",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-564-9116",
            "fax_number": "210-564-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "BRANDY",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.