Bethany S Gourley, PHD in Dearborn, MI - Medicare Psychologist Provider

Bethany S Gourley, PHD is a medicare enrolled "Psychologist - Clinical" provider in Dearborn, Michigan. Her current practice location is 19855 Outer Dr Ste 300, Dearborn, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 359-1977.

Bethany S Gourley is licensed to practice in Michigan (license number 6301019229) 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 1538784012.

Contact Information

	Bethany S Gourley, PHD
	19855 Outer Dr Ste 300, Dearborn, MI 48124-2022
	(313) 359-1977
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Bethany S Gourley
Gender	Female
Speciality	Psychologist - Clinical
Location	19855 Outer Dr Ste 300, Dearborn, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1538784012
Provider Enumeration Date: 06/10/2020
Last Update Date: 08/22/2023

Medicare PECOS Information:

PECOS PAC ID: 9234595489
Enrollment ID: I20230515001428

Medical Identifiers

Medical identifiers for Bethany S Gourley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538784012	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	6301019229 (Michigan)	Secondary
103TC0700X	Psychologist - Clinical	6301019229 (Michigan)	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. Bethany S Gourley allows following entities to bill medicare on her behalf.

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

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. Bethany S Gourley 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
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

Reviews and Comments

Psychologist in Dearborn, MI

Sara Pierce, M.S., TLLP Psychologist Medicare: Not Enrolled in Medicare 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
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
Laurene Saad-younis, Psychologist Medicare: Accepting Medicare Assignments Practice Location: 5808 Schaefer Rd, Dearborn, MI 48126 Phone: 313-467-4653
Dr. Maritaconstance Supan, PH.D., LLP, DAPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 934 Mason St, Dearborn, MI 48124 Phone: 313-278-8053 Fax: 313-278-8053

Bethany S Gourley, PHD - Medicare Psychologist in Dearborn, MI