MRS. BETHANY LAURA CONNOLLY (LICSW) – Clinical Social Worker, NPI 1750448577

MRS. BETHANY LAURA CONNOLLY (LICSW) is a healthcare provider. based in Worcester, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 114558 (MA). The NPI Number for MRS. BETHANY LAURA CONNOLLY (LICSW) is 1750448577

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
MRS. BETHANY LAURA CONNOLLY (LICSW)
NPI
1750448577
Phone
(508) 890-6519
Address
81 PLANTATION ST
Enumeration Date
2 January 2007
Last Update Date
28 August 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5084596400
Graduation Year
2004 (22 years ago)
PAC ID
9032330618
Group Practice PAC ID
9638190374
Professional Enrollment ID
I20141023002001
Address ID
MA016062738WO135XXBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for MRS. BETHANY LAURA CONNOLLY (LICSW)

  • 81, Plantation Street, Rice Square, Worcester, Worcester County, Massachusetts, 01604, United States

    WORCESTER, MA 016043069

    Phone: (508) 890-6519

    Fax: (508) 363-0562

    Type: Location

  • 39 ONEIL ST

    HUDSON, MA 017491618

    Phone: (508) 612-3470

    Fax: (508) 363-0562

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-10-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141023002001IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638190374View full group profile
NameSpecialtyState
Mental Health CounselorMA
Mental Health CounselorMA
P S Y C H I A T R YMA
Clinical PsychologistMA
Clinical PsychologistAK
Mental Health CounselorMA
Nurse PractitionerMA
P S Y C H I A T R YMA
Marriage And Family TherapistMA
Nurse PractitionerRI

Reviews

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Frequently asked questions

How do I look up MRS. BETHANY LAURA CONNOLLY (LICSW) by NPI?
Use NPI 1750448577 when you need to reference MRS. BETHANY LAURA CONNOLLY (LICSW) in forms, claims, or directories.
Does this profile mean MRS. BETHANY LAURA CONNOLLY (LICSW) is currently active?
Yes — MRS. BETHANY LAURA CONNOLLY (LICSW) appears active in the national provider directory.
What field does MRS. BETHANY LAURA CONNOLLY (LICSW) work in?
You can think of MRS. BETHANY LAURA CONNOLLY (LICSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is MRS. BETHANY LAURA CONNOLLY (LICSW)'s primary listing?
We display Worcester, Massachusetts because that is what the record indicates for MRS. BETHANY LAURA CONNOLLY (LICSW).
What if Worcester, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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