Individual provider Active NPI

Bethany K Davey, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1497928790
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8861339 Issued in ID
Practice address
10096 W Fairview Ave Ste 160
Boise, ID 83704-5004
Phone
(208) 908-7882
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 8861339 ID Primary

Addresses

Primary practice location

10096 W Fairview Ave Ste 160
Boise, ID 83704-5004

Mailing address

10096 W Fairview Ave Ste 160
Boise, ID 83704-5004
Phone (208) 908-7882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250206002865 ID Practitioner - Clinical Social Worker 3173053055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avanzar Wellness LLC CurrentSince Jan 8, 2025 Accepting new patients

Locations

11513 W Fairview Ave
Ste 105
Boise, ID 83713
Phone (208) 908-7882

10096 W Fairview Ave
Ste 160
Boise, ID 83704
Phone (208) 908-7882

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": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1497928790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10096 W FAIRVIEW AVE STE 160",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045004",
            "telephone_number": "208-908-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10096 W FAIRVIEW AVE STE 160",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045004",
            "telephone_number": "208-908-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVEY",
        "first_name": "BETHANY",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.