Individual provider Active NPI

Divya Brahmbhatt, LCSW

  • Clinical Social Worker
  • Missouri City, TX
National Provider Identifier
1881232122
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62374 Issued in TX
Practice address
4502 Riverstone Blvd Ste 601
Missouri City, TX 77459-5205
Phone
(609) 576-1774
NPI assigned
Dec 17, 2019
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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 62374 TX Primary

Addresses

Primary practice location

4502 Riverstone Blvd Ste 601
Missouri City, TX 77459-5205

Mailing address

2014 Hughes Ranch Rd
Houston, TX 77089-2844
Phone (609) 576-1774

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
I20200116000282 TX Practitioner - Clinical Social Worker 6608201884 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62374TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Apr 15, 2020 Accepting new patients
Doctor on Demand Professionals P C CurrentSince Oct 4, 2023 Accepting new patients
Oria, LLC CurrentSince Jul 14, 2021 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104

211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411

3106 S W S Young Dr
Ste B202
Killeen, TX 76542
Phone (254) 628-0056

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Interoperability endpoints

  • Direct secure messaging: divya.brahmbhatt.1@30520.direct.athenahealth.com

Organizations & group practices 3

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": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1881232122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 HUGHES RANCH RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770892844",
            "telephone_number": "609-576-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 RIVERSTONE BLVD STE 601",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595205",
            "telephone_number": "609-576-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMBHATT",
        "first_name": "DIVYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.