Active NPI
Bethany Wybert
- Professional Counselor
- Moberly, MO
National Provider Identifier
1730758012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2017021782
- Practice address
- 1624 Gratz Brown St
Moberly, MO 65270-1993 - Phone
- (302) 373-3719
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2017021782 | MO | Primary |
Addresses
Primary practice location
1624 Gratz Brown St
Moberly, MO 65270-1993
Mailing address
1210 Concannon St
Moberly, MO 65270-1206
Phone (302) 373-3719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017021782 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1730758012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 CONCANNON ST",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652701206",
"telephone_number": "302-373-3719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 GRATZ BROWN ST",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652701993",
"telephone_number": "302-373-3719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYBERT",
"first_name": "BETHANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2017021782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moberly, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.