Bethany Renae Aubuchon, LCSW
Individual provider Active NPI Clinical Social Worker · Potosi, MO
NPI 1689275992 · NPPES record last updated Feb 12, 2025
Key facts
- NPI
- 1689275992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2017027968 (MO)
- Practice address
- 1 Southtowne Dr
Potosi, MO 63664-5729 - Phone
- (573) 438-9355
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210729003543 | MO | Practitioner - Clinical Social Worker | 2567865462 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017027968 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Mines Health Center | Current |
Accepting new patients | |
| Great Mines Health Center | Current |
Accepting new patients | |
| Rocky Creek Youth Ranch Incorportated | Past |
Accepting new patients |
Locations
508 W Pine St
Farmington, MO 63640
Phone (573) 664-1100
1 Southtowne Dr
Potosi, MO 63664
Phone (573) 438-8401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2017027968 | MO | Yes |
Addresses
Primary practice location
1 Southtowne Dr
Potosi, MO 63664-5729
Mailing address
1286 Matthews LN
Park Hills, MO 63601-7207
Phone (573) 562-7751
Other practice location 1
508 W Pine St
Farmington, MO 63640-1426
Phone (573) 664-1100
Other providers in Potosi, MO
- Air Evac EMS Inc
- Kamal Akhtar
- David Orie Albert Sr.
- Patricia Louise Allen
- Ally Care LLC
- Austin Plaza Pharmacy Inc
- Michelle Danielle Barnes
- Michael Dennis Barnum
- Timothy Will Christopher Bass
- Kallie Belfield
All providers in Potosi, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.