Bethel Berhanu

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB61274683 Issued in WA

Practice address

24120 Van Ry Blvd Ste 400
Mountlake Terrace, WA 98043-5459

Phone

(425) 245-9940

NPI assigned

May 10, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Maxim Healthcare Services Inc.

  • Community/Behavioral Health Agency
  • Mountlake Terrace, WA
  • NPI 1477051993
  NPD (past)
• Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Mountlake Terrace, WA
  • NPI 1932206380
  NPD (past)

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1942946199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24120 VAN RY BLVD STE 400",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435459",
            "telephone_number": "425-245-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24120 VAN RY BLVD STE 400",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435459",
            "telephone_number": "425-245-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERHANU",
        "first_name": "BETHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61274683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Anthony Baylon
• Diandrea Joan Beckman, MSW, LSWAIC
• Behavior Interventionists of Puget Sound
• Jozette B Bell
• Shelby Marie-Musu Bennett, PTA
• Jennifer Leigh Bernard
• Craig Edward Bernhart, D.D.S.
• Stacy Bertsch, LMP
• Courtney Lee Binnion, LMHCA
• Tanya Birchler, PMHNP-BC, CARN-AP

• Behavior Technician in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.