Active NPI
Beth A Friess, LCSW
- Clinical Social Worker
- Wallingford, CT
National Provider Identifier
1972898575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005943
- Practice address
- 15 S Elm St Ste 1D
Wallingford, CT 06492-4741 - Phone
- (203) 430-9986
- NPI assigned
- Jun 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005943 | CT | Primary |
Addresses
Primary practice location
15 S Elm St Ste 1D
Wallingford, CT 06492-4741
Mailing address
39 Eaton Dr
Wallingford, CT 06492-4719
Phone (203) 430-9986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110712000286 | CT | Practitioner - Clinical Social Worker | 0749458040 | Practice locations: Wallingford, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
15 S Elm St
Suite 1D
Wallingford, CT 06492-4741
Phone (203) 430-9986
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005943 | CT | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633824000000",
"number": "1972898575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 EATON DR",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064924719",
"telephone_number": "203-430-9986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 S ELM ST STE 1D",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064924741",
"telephone_number": "203-430-9986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIESS",
"first_name": "BETH",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-13",
"last_updated": "2021-10-10",
"certification_date": "2021-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.