Alyssa Banham, LMSW
Individual provider Active NPI Social Worker · Buda, TX
NPI 1497108203 · NPPES record last updated Jul 16, 2016
Key facts
- NPI
- 1497108203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 62525 (TX)
- Practice address
- 13207 Wright Rd
Buda, TX 78610-5000 - Phone
- (512) 697-8600
- NPI assigned
- Jul 16, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62525 | TX | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 62525 | TX | Yes |
Addresses
Primary practice location
13207 Wright Rd
Buda, TX 78610-5000
Mailing address
1016 Camino la Costa
Apt 1901
Austin, TX 78752-3846
Other providers in Buda, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.