Bethany Anne Petrous, LLBSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802091198 Issued in MI

Practice address

15222 E Jefferson Ave
Grosse Pointe Park, MI 48230-1314

Phone

(313) 825-2403

NPI assigned

Jun 15, 2021

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

Enrolled in MI

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hegira Health IncGroup PAC ID 3173429560, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Hegira Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westland, MI
  • NPI 1184684979

  MI

  Medicare reassignment Care Compare group
• Adult Well Being Services

  • Case Management Agency
  • Detroit, MI
  • NPI 1023353984
  NPD (past)

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1972171122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 FIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142321",
            "telephone_number": "313-825-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15222 E JEFFERSON AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301314",
            "telephone_number": "313-825-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROUS",
        "first_name": "BETHANY",
        "middle_name": "ANNE",
        "credential": "LLBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802091198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Palmer-Hughes, PHD
• Lawrence Pan, MD
• Park Pharmacy Inc
• Michael J Pasqual, RPH
• Judith Carol Paul, RPH
• Pointes of Care
• Kourtney R Price, MA, LLC
• Pro Nurse LLC
• Pro Staff Stat LLC
• Gokulraj Ramachandran

• All providers in Grosse Pointe Park, MI
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.