| Bethany S Gourley, PHD | |
|
19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 | |
| (313) 359-1977 | |
| Not Available |
| Full Name | Bethany S Gourley |
|---|---|
| Gender | Female |
| Speciality | Clinical Psychologist |
| Experience | 7 Years |
| Location | 19855 Outer Dr Ste 300, Dearborn, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538784012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301019229 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301019229 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Corewell Health William Beaumont University Hospit | Royal oak, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Beaumont Medical Group- Specialty Services | 7214299866 | 868 |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany S Gourley, PHD 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 Ph: (313) 359-1977 | Bethany S Gourley, PHD 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 Ph: (313) 359-1977 |
Sara Pierce, M.S., TLLP Psychologist Medicare: Medicare Enrolled Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Ms. Jessica Dawn Clemons, MA, TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1 Parklane Blvd Ste 200e, Dearborn, MI 48126 Phone: 313-846-2606 Fax: 313-846-2657 |
Yasmeen Saba El-masry, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Kalee Lapointe, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste D160, Dearborn, MI 48124 Phone: 325-716-5223 |
Mr. Giovanni Vitale Ii, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 23061 Nona St, Dearborn, MI 48124 Phone: 313-969-7750 |
Layla Obad, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Karli Aliya Carpenter, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19855 Outer Dr Ste 300, Dearborn, MI 48124 Phone: 313-359-1977 Fax: 313-730-1677 |