NPIMap

Organization Active NPI

Bethany Christian Services

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1235479700
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CB630200978 Issued in MI
Legal business name
BETHANY CHRISTIAN SERVICES
Practice address
2470 Collingwood St Ste 210
Detroit, MI 48206-1500
Phone
(248) 414-4085
Fax
(248) 414-4085
NPI assigned
Feb 21, 2013
Last updated
Feb 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BETHANY CHRISTIAN SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Authorized official

Name
Starr Allen-Pettway, LMSW
Title
Branch Director
Phone
(248) 414-4085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CB630200978 MI Primary

Addresses

Primary practice location

2470 Collingwood St Ste 210
Detroit, MI 48206-1500

Mailing address

2470 Collingwood St Ste 210
Detroit, MI 48206-1500
Phone (248) 414-4085

National Provider Directory

National Provider Directory
Tax ID family
Bethany Christian Services Inc18 organizations share this tax ID, including this one
Part of
Bethany Christian Services Inc

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

2470 Collingwood St
Ste 210
Detroit, MI 48206
Phone (248) 414-4085

30685 Barrington St
Ste 140
Madison Heights, MI 48071
Phone (248) 414-4080

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1235479700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 COLLINGWOOD ST STE 210",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061500",
            "telephone_number": "248-414-4085",
            "fax_number": "248-414-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 COLLINGWOOD ST STE 210",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061500",
            "telephone_number": "248-414-4085",
            "fax_number": "248-414-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY CHRISTIAN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETHANY CHRISTIAN SERVICES",
        "enumeration_date": "2013-02-21",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "ALLEN-PETTWAY",
        "authorized_official_first_name": "STARR",
        "authorized_official_title_or_position": "BRANCH DIRECTOR",
        "authorized_official_telephone_number": "248-414-4085",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "CB630200978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.