Individual provider Active NPI

Theresa Bettmann, MSW, LMSW

  • Social Worker
  • Springfield, MO
National Provider Identifier
1609247121
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2015031752 Issued in MO
Practice address
614 South Ave
Springfield, MO 65806-3110
Phone
(417) 869-9011
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2015031752 MO Primary

Addresses

Primary practice location

614 South Ave
Springfield, MO 65806-3110

Mailing address

614 South Ave
Springfield, MO 65806-3110
Phone (417) 869-9011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240923000536 MO Practitioner - Clinical Social Worker 2365983087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 S Ave
Springfield, MO 65806-3110
Phone (417) 869-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015031752MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Betty and Bobby Allison Ozarks Counseling Center CurrentSince Jul 5, 2024 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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1609247121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 SOUTH AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658063110",
            "telephone_number": "417-869-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 SOUTH AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658063110",
            "telephone_number": "417-869-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTMANN",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "MSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2015031752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.