Individual provider Active NPI

Daniel Claude Bethel, LMSW

  • Clinical Social Worker
  • Wyoming, MI
National Provider Identifier
1386984227
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090546 Issued in MI
Practice address
255 Colrain St SW Ste 2
Wyoming, MI 49548-1013
Phone
(616) 988-1479
NPI assigned
Feb 28, 2013
Last updated
Feb 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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 6801090546 MI Primary

Addresses

Primary practice location

255 Colrain St SW Ste 2
Wyoming, MI 49548-1013

Mailing address

255 Colrain St SW Ste 2
Wyoming, MI 49548-1013
Phone (616) 988-1479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20130729000578 MI Practitioner - Clinical Social Worker 7214178557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2118 3 Mile Rd NW
Grand Rapids, MI 49544-1425
Phone (616) 222-3720

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801090546MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Apr 6, 2013 Accepting new patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Apr 6, 2013 Accepting new patients
Family Outreach Center Past Accepting new patients

Locations

2118 3 Mile Rd NW
Walker, MI 49544
Phone (616) 222-3720

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1386984227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 COLRAIN ST SW STE 2",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495481013",
            "telephone_number": "616-988-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 COLRAIN ST SW STE 2",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495481013",
            "telephone_number": "616-988-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEL",
        "first_name": "DANIEL",
        "middle_name": "CLAUDE",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.