Individual provider Active NPI

Bethany M Moran, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1679168371
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15348 Issued in FL
Practice address
17595 S Tamiami TRL Ste 225
Fort Myers, FL 33908-4819
Phone
(239) 898-0094
Fax
(239) 362-2466
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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 SW15348 FL Primary

Addresses

Primary practice location

17595 S Tamiami TRL Ste 225
Fort Myers, FL 33908-4819

Mailing address

17595 S Tamiami TRL Ste 225
Fort Myers, FL 33908-4819
Phone (239) 898-0094

Other names 1

  • Miss Bethany M Waricka Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210602001864 FL Practitioner - Clinical Social Worker 2668871260 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17595 S Tamiami TRL
Suite 225
Fort Myers, FL 33908-4819
Phone (239) 898-0094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15348FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Linings Consulting LLC Clinical CurrentSince Feb 8, 2021 Accepting new patients

Locations

17595 S Tamiami Trl
Ste 225
Fort Myers, FL 33908
Phone (239) 898-0094

19451 S Tamiami Trl
Ste 12
Fort Myers, FL 33908
Phone (239) 299-9787

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1679168371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17595 S TAMIAMI TRL STE 225",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084819",
            "telephone_number": "239-898-0094",
            "fax_number": "239-362-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17595 S TAMIAMI TRL STE 225",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084819",
            "telephone_number": "239-898-0094",
            "fax_number": "239-362-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "BETHANY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "WARICKA",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.