Individual provider Active NPI

Bettina J Bove, LCSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1255766895
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073413-1 Issued in NY
Practice address
20 Candlewood Path
Dix Hills, NY 11746-5304
Phone
(516) 673-6171
Fax
(516) 586-3457
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073413-1 NY Primary

Addresses

Primary practice location

20 Candlewood Path
Dix Hills, NY 11746-5304

Mailing address

56 Jerome Dr
Farmingdale, NY 11735-1800
Phone (516) 673-6171

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

State licenses

LicenseStateTypeSpecialty
073413-1NYMDClinical Social Worker
073413NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Nassau Guidance Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1255766895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 JEROME DR",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117351800",
            "telephone_number": "516-673-6171",
            "fax_number": "516-586-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CANDLEWOOD PATH",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465304",
            "telephone_number": "516-673-6171",
            "fax_number": "516-586-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVE",
        "first_name": "BETTINA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073413-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.