Individual provider Active NPI

Betsy Lynn Vickers, LMSW

  • Mental Health Counselor
  • Jackson, MI
National Provider Identifier
1790083574
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801090038 Issued in MI
Practice address
5750 Slayton Rd
Jackson, MI 49201-8793
Phone
(517) 944-0111
NPI assigned
Mar 3, 2011
Last updated
Mar 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801090038 MI Primary

Addresses

Primary practice location

5750 Slayton Rd
Jackson, MI 49201-8793

Mailing address

5750 Slayton Rd
Jackson, MI 49201-8793
Phone (517) 944-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120920000452 MI Practitioner - Clinical Social Worker 7315195120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Healing Place LLCGroup PAC ID 0547575029, 14 clinicians

Practice addresses (Care Compare)

207 1St St
Jackson, MI 49201-2102
Phone (517) 998-4673

209 1St St
Jackson, MI 49201-2102
Phone (517) 998-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital CurrentSince Jul 19, 2012 Accepting new patients
W. a. Foote Memorial Hospital, Inc. Social Worker Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jul 19, 2012 Accepting new patients
Healing and Becoming, PLLC Mental Health PastSince Jun 20, 2015 Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1790083574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 SLAYTON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018793",
            "telephone_number": "517-944-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 SLAYTON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018793",
            "telephone_number": "517-944-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "BETSY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801090038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.