Bethany Raye Borrenpohl, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.07552 Issued in IL

Practice address

13317 County Highway 12
Venedy, IL 62214-1103

Phone

(618) 317-1537

NPI assigned

Sep 3, 2015

Last updated

Sep 3, 2015By the provider in NPPES

Sex

Female

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

Enrolled in IL

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Well Counseling ServicesGroup PAC ID 5991002420, 14 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Live Well Counseling Services

  • Clinical Social Worker
  • Venedy, IL
  • NPI 1881055838
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1861860124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13317 COUNTY HIGHWAY 12",
            "city": "VENEDY",
            "state": "IL",
            "postal_code": "622141103",
            "telephone_number": "618-317-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13317 COUNTY HIGHWAY 12",
            "city": "VENEDY",
            "state": "IL",
            "postal_code": "622141103",
            "telephone_number": "618-317-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRENPOHL",
        "first_name": "BETHANY",
        "middle_name": "RAYE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.07552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Elizabeth Denzin, MSW, M.ED, LCSW
• Lowella Jean Domenech
• Christina Marie Gall
• Brittany Graham, MSW, LCSW
• Live Well Counseling Services

• Clinical Social Worker in Venedy, IL
• Providers in Venedy, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.