Individual provider Active NPI

Bettsie E Specia, LCSW LMFT

  • Social Worker
  • San Antonio, TX
National Provider Identifier
1467537225
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S03925 Issued in TX
Practice address
8301 Broadway St
Ste 112
San Antonio, TX 78209-2066
Phone
(210) 821-5980
Fax
(210) 821-6121
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S03925 TX Primary
Marriage & Family Therapist 106H00000X 3226 TX

Addresses

Primary practice location

8301 Broadway St
Ste 112
San Antonio, TX 78209-2066

Mailing address

8301 Broadway St
Ste 112
San Antonio, TX 78209-2066
Phone (210) 821-5980

Other identifiers 1

IdentifierTypeStateIssuer
064237301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100803001225 TX Practitioner - Clinical Social Worker 5092848614 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8301 Broadway St
Suite 112
San Antonio, TX 78209-2066
Phone (210) 821-5980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3226TXMDBehavioral Analyst
S03925TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Elder Care, Inc. Social Worker Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1467537225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 BROADWAY ST",
            "address_2": "STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092066",
            "telephone_number": "210-821-5980",
            "fax_number": "210-821-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 BROADWAY ST",
            "address_2": "STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092066",
            "telephone_number": "210-821-5980",
            "fax_number": "210-821-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECIA",
        "first_name": "BETTSIE",
        "middle_name": "E",
        "credential": "LCSW LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "S03925",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "3226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064237301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.