Individual ProviderDestiny BetheaCase Manager/Care CoordinatorOther Service ProvidersPractice Address1418 Marion Barry Ave SE, Washington, DC 20020(202) 796-5000PECOS EnrollmentBased on the most recent information from CMS, provider Destiny Bethea does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1609612456Provider TypeIndividualFull NameBethea, DestinyGenderFemaleSole ProprietorNoEnumeration Date7/2/2024Last Updated7/9/2024Contact InformationPractice LocationPractice Address1418 Marion Barry Ave SE, Washington, DC 20020Phone(202) 796-5000FaxUnlisted FaxMailing LocationMailing Address1418 Marion Barry Ave SE, Washington, DC 20020PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer