NPIMap

Organization Active NPI

Brainwise Psychotherapy PLLC

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1194570267
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BRAINWISE PSYCHOTHERAPY PLLC
Practice address
555 W Crosstown Pkwy Ste 401
Kalamazoo, MI 49008-1980
Phone
(269) 389-9502
Fax
(269) 360-4806
NPI assigned
Apr 22, 2024
Organization subpart
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

Authorized official

Name
Bethany Vinatieri, LMSWNPI 1053743385
Title
Owner
Phone
(951) 675-3590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

555 W Crosstown Pkwy Ste 401
Kalamazoo, MI 49008-1980

Mailing address

PO Box 3272
Saginaw, MI 48605-3272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240530001483 MI Part B Supplier - Clinic/Group Practice 5294177622 Receives reassigned benefits from 12 practitioners
Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1194570267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W CROSSTOWN PKWY STE 401",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081980",
            "telephone_number": "269-389-9502",
            "fax_number": "269-360-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINWISE PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "VINATIERI",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-675-3590",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.