Individual provider Active NPI

Bethanie Brooke Langloss, LMSW

  • Clinical Social Worker
  • Marshalltown, IA
National Provider Identifier
1508121500
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008036 Issued in IA
Practice address
412 E Church St
Marshalltown, IA 50158-2947
Phone
(641) 753-4021
Fax
(641) 753-4025
NPI assigned
Jul 6, 2012
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 008036 IA Primary

Addresses

Primary practice location

412 E Church St
Marshalltown, IA 50158-2947

Mailing address

9943 Hickman Rd
Suite 105
Urbandale, IA 50322-5304
Phone (515) 248-1447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008036IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1508121500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9943 HICKMAN RD",
            "address_2": "SUITE 105",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503225304",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E CHURCH ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582947",
            "telephone_number": "641-753-4021",
            "fax_number": "641-753-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLOSS",
        "first_name": "BETHANIE",
        "middle_name": "BROOKE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.