Individual provider Active NPI

Bettina Yanez, LCSW

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1104159789
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081223 Issued in NY
Practice address
25 Melville Park Rd Ste 53
Melville, NY 11747-3175
Phone
(631) 204-3434
Fax
(917) 997-8950
NPI assigned
Sep 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 081223 NY Primary
Clinical Social Worker 1041C0700X SW19991 FL

Addresses

Primary practice location

25 Melville Park Rd Ste 53
Melville, NY 11747-3175

Mailing address

PO Box 895123
Leesburg, FL 34789-5123
Phone (352) 234-3807

Other practice location 1

600 Market St
Leesburg, FL 34748-5143
Phone (352) 234-3807

Other identifiers 4

IdentifierTypeStateIssuer
03213238MedicaidNY
081223-1OtherNYLICENSE
6849690OtherNYLICENSE
SW19991OtherFLLICENSE

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
I20241127000701 FL Practitioner - Clinical Social Worker 5698200624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32211
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW19991FLMDClinical Social Worker
081223NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Find Peace Counseling LCSW PLLC Clinical PastSince Oct 27, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6501 Arlington Expy
Ste B105
Jacksonville, FL 32211
Phone (904) 302-9355

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": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1104159789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 895123",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347895123",
            "telephone_number": "352-234-3807",
            "fax_number": "516-351-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MELVILLE PARK RD STE 53",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473175",
            "telephone_number": "631-204-3434",
            "fax_number": "917-997-8950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Market St",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485143",
            "country_code": "US",
            "telephone_number": "352-234-3807",
            "fax_number": "516-351-1912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "BETTINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081223",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03213238",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "081223-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6849690",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SW19991",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.