Colleen Bethel, MSW, Licsw, L.L.C.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COLLEEN BETHEL, MSW, LICSW, L.L.C.

Practice address

1904 44TH Ave N
Minneapolis, MN 55412-1210

Phone

(612) 529-5146

NPI assigned

Mar 23, 2021

Last updated

May 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Colleen Patricia Havlin Bethel, LICSWNPI 1598064016

Title

Owner

Phone

(612) 562-7988

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colleen Patricia Havlin Bethel, MSW, LICSW

  • Clinical Social Worker
  • Coon Rapids, MN
  • NPI 1598064016
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1437735073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 44TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121210",
            "telephone_number": "612-529-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 44TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121210",
            "telephone_number": "612-529-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN BETHEL, MSW, LICSW, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "BETHEL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "PATRICIA HAVLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-562-7988",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1598064016",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "1904 44th Ave N",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554121210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sonja A Colianni, MD
• Jonathan Ramon Colin Rizo, MD
• Mackenzie Colinear, DMD
• Cheyanne Nomi Colip, PA-C
• Collective Mental Health
• Colleen Martens Endrizzi, Inc.
• Colleen Starkey LLC
• Claudia Shaver Colleran, MA
• Jack Colleran, MS
• Jocelyne Collette

• Mental Health Clinic/Center (Including Community Mental Health Center) in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.