Individual provider Active NPI

Bethany J Rocha

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1639426364
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094709 Issued in MI
Practice address
201 Monroe Ave NW
Suite 300
Grand Rapids, MI 49503-2212
Phone
(800) 600-4096
Fax
(800) 606-8839
NPI assigned
Aug 13, 2012
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L2295186 MI
Social Worker 104100000X 6801094709 MI Primary

Addresses

Primary practice location

201 Monroe Ave NW
Suite 300
Grand Rapids, MI 49503-2212

Mailing address

201 Monroe Ave NW
Suite 300
Grand Rapids, MI 49503-2212
Phone (800) 600-4096

Other practice location 1

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 494-4217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141230000120 MI Practitioner - Clinical Social Worker 7618290503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 394-3350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094709MIMDSocial Worker
L2295186MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Mar 19, 2025 Accepting new patients
Holland Community Hospital CurrentSince Mar 19, 2025 Accepting new patients
139 Education, LLC. Past Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1639426364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MONROE AVE NW",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032212",
            "telephone_number": "800-600-4096",
            "fax_number": "800-606-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MONROE AVE NW",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032212",
            "telephone_number": "800-600-4096",
            "fax_number": "800-606-8839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494234918",
            "country_code": "US",
            "telephone_number": "616-494-4217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHA",
        "first_name": "BETHANY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "L2295186",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.