NPIMap

Organization Active NPI

Judy Bannister, LLC

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1225404544
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004283A Issued in IN
Legal business name
JUDY BANNISTER, LLC
Practice address
5455 W 86TH St Ste 102
Indianapolis, IN 46268-1536
Phone
(317) 762-0888
NPI assigned
Aug 20, 2015
Last updated
Jul 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Authorized official

Name
Judy A Bannister, LCSW, LCAC, SAP, NCCNPI 1518300672
Title
Owner/President
Phone
(317) 670-9413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 87001400A IN
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 34004283A IN Primary

Addresses

Primary practice location

5455 W 86TH St Ste 102
Indianapolis, IN 46268-1536

Mailing address

5455 W 86TH St Ste 102
Indianapolis, IN 46268-1536
Phone (317) 762-0888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1225404544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 W 86TH ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681536",
            "telephone_number": "317-762-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 W 86TH ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681536",
            "telephone_number": "317-762-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY BANNISTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "BANNISTER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "317-670-9413",
        "authorized_official_credential": "LCSW, LCAC, SAP, NCC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001400A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004283A",
            "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 Jul 22, 2016; 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.