Individual provider Active NPI

Karanequa Latrice Bagnerise, LCSW

  • Counselor
  • Bedford, TX
National Provider Identifier
1790145878
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2232 Cottonwood LN
Bedford, TX 76021-5114
Phone
(619) 368-3601
NPI assigned
Mar 2, 2016
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary
Clinical Social Worker 1041C0700X 109080 TX
Clinical Social Worker 1041C0700X 26080 FL

Addresses

Primary practice location

2232 Cottonwood LN
Bedford, TX 76021-5114

Mailing address

2232 Cottonwood LN
Bedford, TX 76021-5114

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
I20260226000341 TX Practitioner - Clinical Social Worker 5395226427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5014 Barlow Dr
Round Rock, TX 78681-5531

6101 W Courtyard Dr
Suite 2 225
Austin, TX 78730-5044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109080TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
US Televero Health PA CurrentSince Jan 19, 2026 Accepting new patients

Locations

6101 W Courtyard Dr
Ste 2-225
Austin, TX 78730
Phone (877) 474-0155

Organizations & group practices 1

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1790145878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 COTTONWOOD LN",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 COTTONWOOD LN",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215114",
            "telephone_number": "619-368-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNERISE",
        "first_name": "KARANEQUA",
        "middle_name": "LATRICE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109080",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "26080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.