Kenatta Bethea, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024180834 Issued in VA

Practice address

424 Hamilton Blvd
South Boston, VA 24592-5200

Phone

(434) 572-2936

Fax

(434) 572-4665

NPI assigned

Jan 22, 2021

Last updated

May 21, 2026By 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 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment NPD
• Southside Behavioral Health

  • Community/Behavioral Health Agency
  • Clarksville, VA
  • NPI 1700890761
  Medicare reassignment NPD
• Aspiring Minds Wellness Center, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Suffolk, VA
  • NPI 1477309086
  NPD Authorized official
• Forefront Telecare Inc

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1174035612

  FL

  Medicare reassignment
• Terrinda Alston, PLLC

  dba Renewed Foundations Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Norfolk, VA
  • NPI 1679208011
  NPD (past)

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1376133496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3897 BRIDGE RD STE 104",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351911",
            "telephone_number": "757-654-4342",
            "fax_number": "757-209-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HAMILTON BLVD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925200",
            "telephone_number": "434-572-2936",
            "fax_number": "434-572-4665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3897 Bridge Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234351911",
            "country_code": "US",
            "telephone_number": "757-654-4342",
            "fax_number": "757-209-5477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "KENATTA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024180834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kbethea@southsidebh.org",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "Southside Behavioral Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "424 Hamilton Blvd",
            "city": "South Boston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245925200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "admin@aspiringmindswellness.com",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "Aspiring Minds Wellness Center, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3897 Bridge Rd Ste 104",
            "city": "Suffolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234351911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Habib Fouad Bassil, MD
• Marcus Bates, LCSW
• Novella S Beaver, LCSW
• Behavioral Health Associates, Inc.
• Berry Hill Nursing Home, Inc. (Berry Hill Nursing Home)
• Betts Medical Supplies, LLC.
• Bio-Medical Applications of Virginia, Inc. (Fresenius Kidney Care of Halifax)
• Jennifer N Bohanon
• Michelle Annette Bolgiano, OTR/L
• Rodney Bowen

• Psychiatric/Mental Health Nurse Practitioner in South Boston, VA
• Providers in South Boston, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.