Individual provider Active NPI

Nancy D Bethem, MSW LCSW

  • Clinical Social Worker
  • Folsom, CA
National Provider Identifier
1679664916
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS16992 Issued in CA
Practice address
1000 River Rock Dr
Ste 210
Folsom, CA 95630
Phone
(916) 988-8885
Fax
(916) 987-9749
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS16992 CA Primary

Addresses

Primary practice location

1000 River Rock Dr
Ste 210
Folsom, CA 95630

Mailing address

1000 River Rock Dr
Ste 210
Folsom, CA 95630
Phone (916) 988-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120229000390 CA Practitioner - Clinical Social Worker 9537327036 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2330 Professional Dr
Suite 100
Roseville, CA 95661-7781
Phone (916) 462-7273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16992CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert R. Slater, Jr, MD. Incorporated PastSince Jun 18, 2023 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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679664916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RIVER ROCK DR",
            "address_2": "STE 210",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-988-8885",
            "fax_number": "916-987-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RIVER ROCK DR",
            "address_2": "STE 210",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-988-8885",
            "fax_number": "916-987-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEM",
        "first_name": "NANCY",
        "middle_name": "D",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.