Individual provider Active NPI

Bethany Flores, LCSW

  • Clinical Social Worker
  • Sunrise, FL
National Provider Identifier
1962989004
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16835 Issued in FL
Practice address
14201 W Sunrise Blvd Ste 208
Sunrise, FL 33323-3207
Phone
(954) 282-9856
NPI assigned
Jul 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW16835 FL Primary

Addresses

Primary practice location

14201 W Sunrise Blvd Ste 208
Sunrise, FL 33323-3207

Mailing address

1830 N University Dr Ste 148
Plantation, FL 33322-4114
Phone (954) 282-9856

Other practice location 1

1830 N University Dr # 148
Plantation, FL 33322-4114
Phone (954) 282-9856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW16835FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1962989004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 N UNIVERSITY DR STE 148",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224114",
            "telephone_number": "954-282-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD STE 208",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-282-9856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 N University Dr # 148",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333224114",
            "country_code": "US",
            "telephone_number": "954-282-9856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "BETHANY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-21",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.