Active NPI
Bethany Marie Perez, CSW
- Clinical Social Worker
- Ocean Springs, MS
National Provider Identifier
1477122091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11611229-3502
- Practice address
- 44 Whisperwood LN
Ocean Springs, MS 39564-9214 - Phone
- (303) 594-0059
- NPI assigned
- Jun 18, 2021
- Last updated
- Jun 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11611229-3502 | UT | Primary |
Addresses
Primary practice location
44 Whisperwood LN
Ocean Springs, MS 39564-9214
Mailing address
44 Whisperwood LN
Ocean Springs, MS 39564-9214
Phone (303) 594-0059
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 2, 2024 through Dec 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11611229-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1477122091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 WHISPERWOOD LN",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395649214",
"telephone_number": "303-594-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 WHISPERWOOD LN",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395649214",
"telephone_number": "303-594-0059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "BETHANY",
"middle_name": "MARIE",
"credential": "CSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-18",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "11611229-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.