Individual provider Active NPI

Karlista Peralta, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1780751925
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115539 Issued in TX
Practice address
1160 Dairy Ashford Rd Ste 115
Houston, TX 77079-3022
Phone
(832) 810-8132
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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 115539 TX Primary

Addresses

Primary practice location

1160 Dairy Ashford Rd Ste 115
Houston, TX 77079-3022

Mailing address

PO Box 5424
Katy, TX 77491-5424
Phone (917) 650-1518

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
I20250822001743 TX Practitioner - Clinical Social Worker 0941455216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellaire Ellie Clinic PCGroup PAC ID 4981065596, 4 clinicians

Practice addresses (Care Compare)

2200 Space Park Dr
Suite 240
Houston, TX 77058-3881
Phone (281) 645-5264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115539TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellaire Ellie Clinic PC CurrentSince Sep 1, 2025 Accepting new patients
Elemental Family Services CurrentSince Sep 1, 2025 Accepting new patients
Tangled Wellness LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

6300 West Loop S
Ste 110
Bellaire, TX 77401
Phone (832) 924-0348

1775 Saint James Pl
Ste 325
Houston, TX 77056
Phone (832) 266-7007

2200 Space Park Dr
Ste 240
Houston, TX 77058
Phone (281) 645-5264

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1780751925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5424",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774915424",
            "telephone_number": "917-650-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 DAIRY ASHFORD RD STE 115",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793022",
            "telephone_number": "832-810-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "KARLISTA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "115539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.