BETHANY S GOURLEY PH.D.
NPI 1538784012
Psychologist - Clinical in Dearborn, MI

Q: What is Bethany Gourley's NPI number?

The NPI number for Bethany Gourley is 1538784012. It was assigned to this individual provider in the NPPES registry on June 10, 2020.

Q: What is Bethany Gourley's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Bethany Gourley was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 10, 2020PECOS EnrolledAccepts Medicare Assignment

19855 OUTER DR STE 300, DEARBORN, MI 48124(313) 359-1977 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 22, 2023, Aug 16, 2023, Jul 24, 2023 and 1 more (4 updates tracked since 2020).

On this page

About Bethany S Gourley Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANY S GOURLEY PH.D. (NPI 1538784012) is an individual clinical provider in Dearborn, Michigan, licensed in Michigan (6301019229) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital Royal Oak, and maintains a secondary practice location in Royal Oak.

NPPES Registry Identity

NPI1538784012

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameBETHANY S GOURLEYCredential: PH.D.

Location Address19855 OUTER DR STE 300Dearborn, MI 48124-2022

Mailing Address19855 Outer Dr Ste 300Dearborn, MI 48124-2022 · (313) 359-1977

Phone(313) 359-1977

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateJune 10, 2020

Last NPPES UpdateAugust 22, 20234 updates tracked since enumeration

NPPES CertifiedAugust 22, 2023

✔ NPI 1538784012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MI · 6301019229

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologistTaxonomy 103T00000X · License 6301019229 (MI)

19855 OUTER DR STE 300, Dearborn, MI 48124

Open in Google Maps ↗

Secondary Practice Location 1

Location 13601 W 13 Mile RdRoyal Oak, MI 48073-6712 · Phone (248) 898-0898

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bethany S Gourley Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234595489

PECOS Enrollment IDI20230515001428

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$177.36 typical visit price

range $58.04 – $177.36

Typical copayment $44.34 (range $14.51 – $44.34)

Most-billed visit code 99205

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH WIESE

Social Worker (Clinical)