Active NPI
Bhanumathi Ivatury, PHD LCSW
- Clinical Social Worker
- Carrollton, TX
National Provider Identifier
1487870275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2893
- Practice address
- 1422 Lincoln Dr
Carrollton, TX 75500-1400 - Phone
- (972) 245-4192
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2893 | TX | Primary |
Addresses
Primary practice location
1422 Lincoln Dr
Carrollton, TX 75500-1400
Mailing address
1422 Lincoln Dr
Carrollton, TX 75500-1400
Phone (972) 245-4192
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00S7UT | Other | BCBS TX | |
| LP0008754 | Medicaid | TX |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2893 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487870275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1422 LINCOLN DR",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "755001400",
"telephone_number": "972-245-4192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1422 LINCOLN DR",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "755001400",
"telephone_number": "972-245-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVATURY",
"first_name": "BHANUMATHI",
"name_prefix": "Dr.",
"credential": "PHD LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "2893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TX",
"identifier": "00S7UT",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LP0008754",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.