Individual provider Active NPI

Brianna Danae Cha, LCSW

  • Clinical Social Worker
  • Bloomington, IN
National Provider Identifier
1346751328
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007955A Issued in IN
Practice address
482 S Landmark Ave
Bloomington, IN 47403-5000
Phone
(812) 333-8474
Fax
(812) 961-3804
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 34007955A IN Primary

Addresses

Primary practice location

482 S Landmark Ave
Bloomington, IN 47403-5000

Mailing address

482 S Landmark Ave
Bloomington, IN 47403-5000
Phone (812) 333-8474

Other names 1

  • Brianna Danae Underhill Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20171101000273 IN Practitioner - Clinical Social Worker 9234405572 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. CurrentSince Oct 12, 2017 Accepting new patients
Jennifer Spencer PHD HSPP PC CurrentSince Mar 25, 2022 Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Oct 12, 2017 Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

1312 W Arch Haven Ave
Ste A
Bloomington, IN 47403
Phone (812) 333-8474

482 S Landmark Ave
Bloomington, IN 47403
Phone (812) 333-8474

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

Organizations & group practices 3

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1346751328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035000",
            "telephone_number": "812-333-8474",
            "fax_number": "812-961-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035000",
            "telephone_number": "812-333-8474",
            "fax_number": "812-961-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHA",
        "first_name": "BRIANNA",
        "middle_name": "DANAE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007955A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "UNDERHILL",
            "middle_name": "DANAE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.