Eileen Ellsworth Banados, LCSW
Individual provider Active NPI Clinical Social Worker · Berkeley, CA
NPI 1376796151 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1376796151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW86740 (CA)
- Practice address
- 3017 Telegraph Ave
Berkeley, CA 94705-2049 - Phone
- (510) 926-6677
- NPI assigned
- Oct 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250908000431 | CA | Practitioner - Clinical Social Worker | 1850893082 | Reassigns benefits to 1 organization |
| I20250909001870 | DC | Practitioner - Clinical Social Worker | 1850893082 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW86740 | CA | MD | Clinical Social Worker |
| 5357-C | NV | MD | Clinical Social Worker |
| 86740 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Mental Health | Current |
Accepting new patients |
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
| Foresight Mental Health | Clinical | Past |
Accepting new patients |
| Delespinasse Consulting, Inc | Clinical | Past | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
Interoperability endpoints
- eileen.banados.1@25119.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5357-C | NV | |
| Clinical Social Worker | 1041C0700X | LCSW86740 | CA | Yes |
Addresses
Primary practice location
3017 Telegraph Ave
Berkeley, CA 94705-2049
Mailing address
2999 Atlantic St
Concord, CA 94518-1005
Phone (702) 241-1249
Other practice location 1
900 Karen Ave Ste C207
Las Vegas, NV 89109-1272
Phone (702) 241-1249
Other providers in Berkeley, CA
- Hannah Baloyra
- Jodie Balter
- Elizabeth Ann Baltrip
- Virgilio Y Baluyut
- Agi E Ban
- Leslie Bandle
- Jiveli Banegas
- Cynthia Banks
- Willow Banks
- Cristiana Aragao Baptista
All providers in Berkeley, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.