Michael Bettencourt LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13063 Issued in FL

Legal business name

MICHAEL BETTENCOURT LCSW LLC

Practice address

2805 E Oakland Park Blvd # 174
Fort Lauderdale, FL 33306-1813

Phone

(617) 869-6182

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Bettencourt, LCSW

Title

President

Phone

(617) 869-6182

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda Lee Croke-Dipietro, LICSW

  • Mental Health Counselor
  • Melrose, MA
  • NPI 1740346881
  NPD (past)
• Kimberly Ann Smith-McCue, LICSW

  • Clinical Social Worker
  • Melrose, MA
  • NPI 1124122239
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1891998720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 E OAKLAND PARK BLVD # 174",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061813",
            "telephone_number": "617-869-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 E OAKLAND PARK BLVD # 174",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061813",
            "telephone_number": "617-869-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BETTENCOURT LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "BETTENCOURT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-869-6182",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111335",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1852612",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER NUMBER",
            "identifier": "461417",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "P08075",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miami Road Opco LLC
• Mariela Ines Miccio
• Michael a Chizner MD PA
• Michael B Blum DMD PA
• Michael Barnard DDS PA
• Michael C. Cheung, M.D., P.a.
• Michael H Gordon MD PA
• Michael I Cohen D.C., P.a.
• Alina Michael
• Chelsea Michaels, DNP, FNP-C

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.