Ms Bethany Kelley, MSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
4039 Nicolet Ave, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(747) 403-0461.
Ms Bethany Kelley is licensed to practice in California (license number 108173) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1821439902.
Healthcare Provider's Profile
| Full Name | Ms Bethany Kelley |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4039 Nicolet Ave, Los Angeles, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1821439902
- Provider Enumeration Date: 07/17/2013
- Last Update Date: 12/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759663461
- Enrollment ID: I20170112002003
Medical Identifiers
Medical identifiers for Ms Bethany Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1821439902 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 108173 (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.1500966 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | 108173 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Bethany Kelley allows following entities to bill medicare on her behalf.
| Entity Name | Psychological & Behavioral Consultants Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811915713
PECOS PAC ID: 0446243760
Enrollment ID: O20040405000363 |
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| Entity Name | Wellqor Psychological Services Of California, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093173742
PECOS PAC ID: 6103122171
Enrollment ID: O20170324000526 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Bethany Kelley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Bethany Kelley, MSW, LCSW
5500 York Ln N,
Columbus, OH 43232-1565
Ph: () - | Ms Bethany Kelley, MSW, LCSW
4039 Nicolet Ave,
Los Angeles, CA 90008-2217
Ph: (747) 403-0461 |
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