Bethany R Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008720A Issued in IN

Practice address

3008 Bevcher Dr
Madison, IN 47250-3863

Phone

(812) 265-1918

Fax

(812) 265-1828

NPI assigned

Jul 11, 2016

Last updated

Jan 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• B Johnson, LLC

  dba Bethany Johnson

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, IN
  • NPI 1053078832

  Clinical

  Medicare reassignment NPD Authorized official
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD
• Northern Kentucky Mental Health Mental Retardation Regional Board

  dba NorthKey Community Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covington, KY
  • NPI 1578527610
  NPD (past)
• Northern Kentucky Mental Health Mental Retardation Regional Board

  dba Northkey Community Care

  • Psychiatric Hospital
  • Covington, KY
  • NPI 1679775514
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1336591668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 E MAIN ST",
            "address_2": "STE 2",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503689",
            "telephone_number": "812-339-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 BEVCHER DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503863",
            "telephone_number": "812-265-1918",
            "fax_number": "812-265-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BETHANY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252265",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008720A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610661458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Wortham Counseling Services Inc
• Jefferson County Auditor (Jefferson County Health Department)
• Jefferson County Chiropractic Inc
• Jefferson Lake Emergency Physicians LLC
• Milton Frederick Johanboeke Jr., D.M.D.
• Renee E Johnson, LCSW
• Whitney Renee Johnson, MS, CCC-SLP
• Ajay K Kandra, MD
• Ronald G. Kearschner, M.D.
• Thomas Michael Kennedy, D.D.S.

• Clinical Social Worker in Madison, IN
• Providers in Madison, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.