Bethany Abigail Reyes

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801089605 Issued in MI

Practice address

1777 Axtell Dr
#100
Troy, MI 48084-4404

Phone

(248) 613-5377

NPI assigned

Sep 30, 2016

Last updated

Sep 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1285183327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 KNOWLES ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673718",
            "telephone_number": "248-259-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 AXTELL DR",
            "address_2": "#100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844404",
            "telephone_number": "248-613-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "BETHANY",
        "middle_name": "ABIGAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilire Neurorehabilitation Afc
• Resolute Physical Therapy & Performance LLC
• Colleen Reveley, LMSW
• Revitalize Health and Beauty
• Revive N Renu Mental Health Spa Counseling Services
• Elizabeth Reyes
• Geraldine Reyes, LMSW
• Nancy Lee Reynaert, CRNA
• Christopher Reynolds, FNP-BC
• Elizabeth Reynolds, LMSW

• Clinical Social Worker in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.