Individual provider Active NPI

Marquetese Betts, MSSA, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1366280661
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1700496 Issued in OH
Practice address
3899 Beechmont Oval
Beachwood, OH 44122-4724
Phone
(216) 548-6578
NPI assigned
Jul 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 1700496 OH Primary

Addresses

Primary practice location

3899 Beechmont Oval
Beachwood, OH 44122-4724

Mailing address

3899 Beechmont Oval
Beachwood, OH 44122-4724
Phone (216) 548-6578

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

LicenseStateTypeSpecialty
1700496OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1366280661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3899 BEECHMONT OVAL",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224724",
            "telephone_number": "216-548-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 BEECHMONT OVAL",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224724",
            "telephone_number": "216-548-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTS",
        "first_name": "MARQUETESE",
        "credential": "MSSA, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1700496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.