Individual provider Active NPI

Amanda Bethurem, LMHC

  • Mental Health Counselor
  • Lehigh Acres, FL
National Provider Identifier
1093445587
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH24218 Issued in FL
Practice address
228 Plaza Dr Ste D
Lehigh Acres, FL 33936-6054
Phone
(239) 690-6906
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH24218 FL Primary

Addresses

Primary practice location

228 Plaza Dr Ste D
Lehigh Acres, FL 33936-6054

Mailing address

5216 Billings St
Lehigh Acres, FL 33971-6482
Phone (954) 830-4123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240924002224 FL Practitioner - Mental Health Counselor 9436690989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLC 446 clinicians

Practice addresses (Care Compare)

4310 Metro Pkwy
Suite 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH24218FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Aug 22, 2024 Accepting new patients
Dna Comprehensive Therapy Services, LLC Mental Health CurrentSince Aug 22, 2024 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

228 Plaza Dr
Ste D
Lehigh Acres, FL 33936
Phone (239) 491-8204

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Organizations & group practices 2

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1093445587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 BILLINGS ST",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339716482",
            "telephone_number": "954-830-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PLAZA DR STE D",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366054",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHUREM",
        "first_name": "AMANDA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH24218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.