Individual provider Active NPI

Isha Arredondo Banerjea, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1245700558
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61355 Issued in TX
Practice address
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone
(214) 543-5191
NPI assigned
Nov 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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 15627 TX
Clinical Social Worker 1041C0700X 61355 TX Primary

Addresses

Primary practice location

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Mailing address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone (214) 543-5191

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15627TXMDAddiction (Substance Use Disorder) Counselor
61355TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Action CurrentSince Apr 1, 2021 Accepting new patients
Lotus Rising Atx, PLLC Clinical Current Accepting new patients

Locations

314 E Highland Mall Blvd
Ste 301
Austin, TX 78752
Phone (512) 444-9922

5900 Balcones Dr
Ste 100
Austin, TX 78731

Organizations & group practices 2

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": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1245700558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "214-543-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "214-543-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEA",
        "first_name": "ISHA",
        "middle_name": "ARREDONDO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15627",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "61355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2024; 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.