NPIMap

Individual provider Active NPI

Beatrice Bock, LCSW

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1144396540
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC0020J000 Issued in NJ
Practice address
2 Eves Dr
Ste 104
Marlton, NJ 08053-3193
Phone
(856) 797-8777
Fax
(856) 797-6764
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 44SC0020J000 NJ Primary
Clinical Social Worker 1041C0700X CW012568 PA

Addresses

Primary practice location

2 Eves Dr
Ste 104
Marlton, NJ 08053-3193

Mailing address

421 Chestnut St
#303
Philadelphia, PA 19106-2420
Phone (215) 923-0603

Other names 1

  • Ms. Beaty Bock Professional 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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44SC0020J000NJMDClinical Social Worker
CW012568PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Garden State Behavioar Health Services South LLC Clinical Past Accepting new patients
Centra PC Past Accepting new patients
Dr. Betsy Fernbach LLC PastSince Jun 9, 2015 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1144396540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 CHESTNUT ST",
            "address_2": "#303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191062420",
            "telephone_number": "215-923-0603",
            "fax_number": "856-797-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EVES DR",
            "address_2": "STE 104",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533193",
            "telephone_number": "856-797-8777",
            "fax_number": "856-797-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "BEATRICE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC0020J000",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEATY",
            "last_name": "BOCK",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.