Active NPI
Bethany Anne Clark
- Social Worker
- Topeka, KS
National Provider Identifier
1235739335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11187
- Practice address
- 419 SW 29TH St
Topeka, KS 66611-1105 - Phone
- (785) 409-6801
- NPI assigned
- Oct 28, 2020
- Last updated
- Jan 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11187 | KS | Primary |
Addresses
Primary practice location
419 SW 29TH St
Topeka, KS 66611-1105
Mailing address
419 SW 29TH St
Topeka, KS 66611-1105
Phone (785) 409-6801
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11187 | KS | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KVC Behavioral Healthcare | Current | Accepting new patients |
Locations
419 SW 29th St
Topeka, KS 66611
Phone (785) 409-6801
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Addiction (Substance Use Disorder) Counselor
- Topeka, KS
- NPI 1437767571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1235739335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 SW 29TH ST",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666111105",
"telephone_number": "785-409-6801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 SW 29TH ST",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666111105",
"telephone_number": "785-409-6801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BETHANY",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "11187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
- Vicki Claassen, ARNP
- Clarence M. Kelley Detention Services of Topeka, LLC (Transitional Living Center)
- Clarence M. Kelley Detention Services, Inc. (Forbes Juvenile Attention Center)
- Clarity & Connection LLC
- Michelle Rae Clark-Galvan, APRN, DNP-FNP
- Crystal Lea Clark, APRN-C
- Jaquita B Clark
- Jeffrey B Clark, DDS
- Kathryn M Clark
- Savannah Jewel Clark
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.