Gary Joseph Bettencourt, SUDCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

9127 Issued in CA

Practice address

1101 Sylvan Ave Ste C103
Modesto, CA 95350-1687

Phone

(209) 758-7477

NPI assigned

Oct 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Roots of Addiction Counseling Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Modesto, CA
  • NPI 1740990928

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1689456717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SYLVAN AVE STE C103",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501687",
            "telephone_number": "209-758-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SYLVAN AVE STE C103",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501687",
            "telephone_number": "209-758-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTENCOURT",
        "first_name": "GARY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "SUDCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "9127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britiel Bethishou, DO
• Cassidy Bethke
• Rena Betossib
• Lisa Betschart
• Debbie Bettencourt
• Jordan Bettencourt, B.S.
• Veronica Bettencourt
• David Allen Betz, MD
• Nadia Bevacqua
• Beverly M Hodges Advanced Practice Registered Nursing Inc

• Addiction (Substance Use Disorder) Counselor in Modesto, CA
• Providers in Modesto, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.