Judy A Bannister, LCSW, LCAC, SAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004283A Issued in IN

Practice address

5455W 86TH St 102
Indianapolis, IN 46268-1536

Phone

(317) 762-0888

Fax

(317) 203-0983

NPI assigned

Apr 9, 2013

Last updated

Apr 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Judy Bannister, LLC

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1225404544
  Authorized official Same address or phone
• Colleen Caito Counseling, LLC

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1770030355
  NPD (past)

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1518300672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 W 86TH ST",
            "address_2": "SUITE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681536",
            "telephone_number": "317-762-0888",
            "fax_number": "317-203-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455W 86TH ST 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681536",
            "telephone_number": "317-762-0888",
            "fax_number": "317-203-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "JUDY",
        "middle_name": "A",
        "credential": "LCSW, LCAC, SAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001400A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004283A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Katherine Banks, BSN, RN
• Madison Banks, RBT
• Nicole Marie Banks, RBT
• Feras J Banna, CAA
• Taylor Re'Shae Banner
• Kristin Bannister, AGACNP-BC
• Dima Bannourah, RPH
• Ronald L Banta, DPM
• Amy E Banter, MD
• Diana Lynn Bantz, APRN-BC

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.