Cathy A Bofetta, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2004013225 Issued in MO

Practice address

300 W Cherry St
Nevada, MO 64772-2202

Phone

(417) 667-4230

Fax

(417) 667-7607

NPI assigned

Oct 25, 2006

Last updated

Oct 10, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellness Company VII

  • Clinical Psychologist
  • Nevada, MO
  • NPI 1659625937
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1437234002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CHERRY ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722202",
            "telephone_number": "417-667-4230",
            "fax_number": "417-667-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CHERRY ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647722202",
            "telephone_number": "417-667-4230",
            "fax_number": "417-667-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOFETTA",
        "first_name": "CATHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2004013225",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BGC Health Care Services, Inc. (Joe Clark Residential Care Home)
• Sammie Bishop
• Louis Blea, PLPC
• Heather Bledsaw, LPC
• Sharon Board, PT
• Jama Jelaine Bogart, FNP
• Cody Lee Bond, PSY.D., LCP
• Cassie Jo Boultinghouse, RDH
• Chrystie Lyn Braden, MS, PLPC
• Cindy Layne Brannan, RN

• Clinical Psychologist in Nevada, MO
• Providers in Nevada, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.