Individual provider Active NPI

Eliza Jade S Brown, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1396375622
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62666 Issued in TX
Practice address
13785 Research Blvd Ste 125
Austin, TX 78750-1826
Phone
(817) 504-1716
NPI assigned
Jan 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 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 62666 TX Primary

Addresses

Primary practice location

13785 Research Blvd Ste 125
Austin, TX 78750-1826

Mailing address

13785 Research Blvd Ste 125
Austin, TX 78750-1826
Phone (817) 504-1716

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
62666TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1396375622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13785 RESEARCH BLVD STE 125",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501826",
            "telephone_number": "817-504-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13785 RESEARCH BLVD STE 125",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501826",
            "telephone_number": "817-504-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ELIZA JADE",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62666",
            "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 Sep 25, 2021; 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.