Individual provider Active NPI

Bethany Louise Vinatieri, LMSW

  • Social Worker
  • Portage, MI
National Provider Identifier
1053743385
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801095655 Issued in MI
Practice address
800 E Milham Ave
Portage, MI 49002-1490
Phone
(269) 249-7179
Fax
(269) 459-7149
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801095655 MI Primary

Addresses

Primary practice location

800 E Milham Ave
Portage, MI 49002-1490

Mailing address

800 E Milham Ave
Portage, MI 49002-1490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20151103000902 MI Practitioner - Clinical Social Worker 6507176575 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brainwise Psychotherapy PLLCGroup PAC ID 5294177622, 10 clinicians

Practice addresses (Care Compare)

555 W Crosstown Pkwy
Suite 401
Kalamazoo, MI 49008-1980
Phone (269) 389-9502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095655MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital CurrentSince Sep 23, 2015 Accepting new patients
Bronson Methodist Hospital CurrentSince Aug 12, 2017 Accepting new patients
Brainwise Psychotherapy PLLC Clinical CurrentSince Apr 30, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince Sep 23, 2015 Accepting new patients
Restorative Therapy & Counseling Services Clinical CurrentSince Jul 23, 2021 Accepting new patients

Locations

5629 Stadium Dr
Ste A
Kalamazoo, MI 49009
Phone (269) 372-1000

555 W Crosstown Pkwy
Ste 401
Kalamazoo, MI 49008
Phone (269) 389-9502

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

451 Health Pkwy
Ste E
Paw Paw, MI 49079
Phone (269) 655-3090

800 E Milham Ave
Portage, MI 49002
Phone (269) 249-7179

Organizations & group practices 5

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1053743385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021490",
            "telephone_number": "269-249-7179",
            "fax_number": "269-459-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINATIERI",
        "first_name": "BETHANY",
        "middle_name": "LOUISE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2024-04-22",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.