Individual provider Active NPI

Janell Bethea

  • Clinical Social Worker
  • Arlington, TX
National Provider Identifier
1619684537
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
42025 Issued in TX
Practice address
1201 N Watson Rd Ste 20
Arlington, TX 76006-6190
Phone
(682) 290-9619
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 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 42025 TX Primary

Addresses

Primary practice location

1201 N Watson Rd Ste 20
Arlington, TX 76006-6190

Mailing address

952 Hiawatha LN
Saginaw, TX 76131-4833

Other identifiers 1

IdentifierTypeStateIssuer
7OtherTXTHERAPIST

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL reviivetherapy.com Direct Reviive Therapy

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42025TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1619684537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 HIAWATHA LN",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761314833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N WATSON RD STE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760066190",
            "telephone_number": "682-290-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "JANELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "42025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPIST",
            "identifier": "7",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "reviivetherapy.com",
            "affiliation": "Y",
            "endpointDescription": "website for therapy practice",
            "affiliationName": "Reviive Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 N Watson Rd Ste 20",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760066190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; 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.