Individual provider Active NPI

Annise Prewitt, LCSW

  • Clinical Social Worker
  • Henderson, NV
National Provider Identifier
1992843106
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4262-C Issued in NV
Practice address
600 Whitney Ranch Dr
Suite D-19a
Henderson, NV 89014-2611
Phone
(702) 531-3200
Fax
(702) 531-3201
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4262-C NV Primary

Addresses

Primary practice location

600 Whitney Ranch Dr
Suite D-19a
Henderson, NV 89014-2611

Mailing address

644 Holland Heights Ave
Las Vegas, NV 89123-3717
Phone (702) 460-6498

Other names 1

  • Annise Bywaters Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4262-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992843106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 HOLLAND HEIGHTS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233717",
            "telephone_number": "702-460-6498",
            "fax_number": "702-897-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WHITNEY RANCH DR",
            "address_2": "SUITE D-19A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142611",
            "telephone_number": "702-531-3200",
            "fax_number": "702-531-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "ANNISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "4262-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNISE",
            "last_name": "BYWATERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.