Individual provider Active NPI

Alexa Bryan, MSW, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1285935718
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006719A Issued in IN
Practice address
7165 Clearvista Way
Indianapolis, IN 46256-4621
Phone
(317) 621-7561
Fax
(317) 355-6096
NPI assigned
Nov 15, 2010
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33005496A IN
Clinical Social Worker 1041C0700X 34006719A IN Primary

Addresses

Primary practice location

7165 Clearvista Way
Indianapolis, IN 46256-4621

Mailing address

6626 E 75TH Street
Suite 500
Indianapolis, IN 46250-2890
Phone (317) 621-7561

Other identifiers 2

IdentifierTypeStateIssuer
000000843959OtherINANTHEM BCBS
000000841425OtherINANTHEM BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ABRYAN4788@ECOMMUNITYDIRECT.COM

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
33005496AINMDSocial Worker
34006719AINMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: abryan4788@ecommunitydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1285935718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 CLEARVISTA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564621",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "ALEXA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33005496A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006719A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000843959",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000841425",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABRYAN4788@ECOMMUNITYDIRECT.COM",
            "affiliation": "N",
            "address_1": "7165 Clearvista Way",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462564621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 4, 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.