Individual provider Active NPI

Elizabeth Nyamai, LCSW,CCM

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1598371445
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57800 Issued in TX
Practice address
1400 S Main St Ste 401
Fort Worth, TX 76104-4913
Phone
(817) 702-4921
Fax
(817) 702-3366
NPI assigned
Sep 16, 2020
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 57800 TX Primary
Case Manager/Care Coordinator 171M00000X 4242707

Addresses

Primary practice location

1400 S Main St Ste 401
Fort Worth, TX 76104-4913

Mailing address

1400 S Main St Ste 401
Fort Worth, TX 76104-4913
Phone (817) 702-4921

Other practice location 1

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719002776 TX Practitioner - Clinical Social Worker 5698135861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57800TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adjuvant Behavioral Health Inc Clinical CurrentSince May 24, 2023 Accepting new patients
Adjuvant Behavioral Health Inc CurrentSince May 24, 2023 Accepting new patients

Locations

11754 Jollyville Rd
Ste 110
Austin, TX 78759
Phone (512) 331-2700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1598371445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST STE 401",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044913",
            "telephone_number": "817-702-4921",
            "fax_number": "817-702-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST STE 401",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044913",
            "telephone_number": "817-702-4921",
            "fax_number": "817-702-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYAMAI",
        "first_name": "ELIZABETH",
        "credential": "LCSW,CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57800",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": "4242707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.