Individual provider Active NPI

Chloe Merritt Bethany

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1750914636
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014215 Issued in NC
Practice address
3325 Durham Chapel Hill Blvd Ste 210
Durham, NC 27707-2646
Phone
(919) 443-9905
Fax
(984) 888-0913
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-25653 NC
Clinical Social Worker 1041C0700X P014215 NC Primary

Addresses

Primary practice location

3325 Durham Chapel Hill Blvd Ste 210
Durham, NC 27707-2646

Mailing address

2624 Chapel Hill Rd Apt a
Durham, NC 27707-1958
Phone (843) 991-9074

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

LicenseStateTypeSpecialty
LCAS-25653NCMDAddiction (Substance Use Disorder) Counselor
P014215NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Outreach, LLC PastSince Feb 23, 2020 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": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1750914636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 CHAPEL HILL RD APT A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071958",
            "telephone_number": "843-991-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 DURHAM CHAPEL HILL BLVD STE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072646",
            "telephone_number": "919-443-9905",
            "fax_number": "984-888-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHANY",
        "first_name": "CHLOE",
        "middle_name": "MERRITT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-25653",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.