Bettie Kathleen Koontz, CAS-I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4986-I Issued in CA

Practice address

17727 E Cypress St
Covina, CA 91722-2634

Phone

(626) 967-2677

NPI assigned

Jul 15, 2015

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

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.

• Social Model Recovery Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Covina, CA
  • NPI 1164709895
  NPD (past)

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1366826836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 E CYPRESS ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917222634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17727 E CYPRESS ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917222634",
            "telephone_number": "626-967-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "BETTIE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "CAS-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "4986-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Edward Kodama
• Arianna Koehly
• Kendra Celeste Kohrt, RBT, MS, MFA
• Kok H Chan MD Inc
• Kaite Kong
• Ashley Koop
• Karin Ann Kooyenga Honaker
• Constantine Korovessis
• Donovan Kouthiraj
• Ryan Krajniak, M.A., LMFT

• Addiction (Substance Use Disorder) Counselor in Covina, CA
• Providers in Covina, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.