Bethany K Miletich, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28401 Issued in MN

Practice address

1401 East 1St Street
Duluth, MN 55805

Phone

(218) 728-4491

Fax

(218) 302-8698

NPI assigned

Aug 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bethany K Mahlke Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

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.

• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733
  Medicare reassignment NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• Brightwater Health Dba Human Development Center

  • Community/Behavioral Health Agency
  • Cloquet, MN
  • NPI 1114048527
  NPD (past)

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1790403087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 11th St",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557201817",
            "country_code": "US",
            "telephone_number": "218-879-4559",
            "fax_number": "218-879-0282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022017",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161300",
            "country_code": "US",
            "telephone_number": "218-834-5520",
            "fax_number": "218-834-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052147",
            "country_code": "US",
            "telephone_number": "218-624-5683",
            "fax_number": "218-624-5736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILETICH",
        "first_name": "BETHANY",
        "middle_name": "K",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "MAHLKE",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott Anthony Mikesell, DO
• Nicholas J Milanovich, M.D.
• Corey Steven Milbrandt, DC
• Eda Bette Miles, MD, DC
• Erika M Miles, MD
• Annessa Milinkovich
• Miller Hill Chiropractic, PA
• Miller Hill Dental PLLC
• Aaron David Miller, PH.D.
• Catherine Jean Miller, RN ,CNP

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.