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DR. BETHANY RALLIS PH.D., LCP
NPI 1538837950
Psychologist - Clinical in South Kingstown, RI

Active since August 31, 2021PECOS EnrolledAccepts Medicare Assignment
65 VILLAGE SQUARE DR STE 302, SOUTH KINGSTOWN, RI 02879(401) 785-0040(401) 941-7847 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Bethany Rallis Ph.d., Lcp NPPES

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

DR. BETHANY RALLIS PH.D., LCP (NPI 1538837950) is an individual clinical provider in South Kingstown, Rhode Island, licensed in Rhode Island (PS01879) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1538837950
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. BETHANY RALLISCredential: PH.D., LCP
Location Address65 VILLAGE SQUARE DR STE 302South Kingstown, RI 02879-2569
Mailing Address86 Blueberry LnJamestown, RI 02835-2903 · (401) 954-4283
Phone(401) 785-0040
Fax(401) 941-7847
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateAugust 31, 2021
Last NPPES UpdateAugust 27, 2025
NPPES CertifiedAugust 27, 2025
✔ NPI 1538837950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in RI · PS01879
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.
65 VILLAGE SQUARE DR STE 302, South Kingstown, RI 02879
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Bethany Rallis Ph.d., Lcp 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 ID5395137855
PECOS Enrollment IDI20220113002428
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Bethany Rallis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Child And Family Psychiatry, Inc.
21 mi
Psychiatry
1035 POST RD
Warwick, RI 02888
  • Reassigned Medicare billing, Rhode Island enrollment
  • 158 clinicians in this Medicare group
NPI 1760863229 (401) 785-0040
Lifespan Physician Group, Inc.
25 mi
Psychiatry
593 EDDY STREET
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 315 clinicians in this Medicare group
NPI 1548506793 (401) 444-7442

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02879 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
$177.03 typical visit price
range $58.57 – $177.03
Typical copayment $44.25 (range $14.64 – $44.25)
Most-billed visit code 99205
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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 20

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

LAURA DAVIDSON NP
Nurse Practitioner (Psychiatric/Mental Health)
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040
APRILE ROSE DALEY LICSW
Social Worker (Clinical)
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040
DEBORAH D'AMICO BERGNER LICSW
Social Worker (Clinical)
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040
DANIELA MONICA ZBONA PHD
Psychologist
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040
ABIGAIL OWEN POST DOCTORATE
Student in an Organized Health Care Education/Training Program
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (877) 910-1878
JODY ANN EYRE LMFT
Marriage & Family Therapist
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040
RACHEL F MIKUTEL PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (310) 905-2111
MS. LAURIE JEAN HARPER PH.D, LMHC-A
Counselor (Mental Health)
65 VILLAGE SQUARE DR STE 302
SOUTH KINGSTOWN, RI 02879
Washington County (401) 785-0040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Rallis's NPI number?

The NPI number for Bethany Rallis is 1538837950. It was assigned to this individual provider in the NPPES registry on August 31, 2021.

Where is Bethany Rallis located?

Bethany Rallis practices at 65 Village Square Dr Ste 302, South Kingstown, RI 02879. The listed phone number is (401) 785-0040.

What is Bethany Rallis's specialty?

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

Is Bethany Rallis enrolled in Medicare?

Yes. Bethany Rallis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Bethany Rallis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bethany Rallis reassigns Medicare benefits to 2 organizations: Child And Family Psychiatry, Inc. (Warwick, RI) and Lifespan Physician Group, Inc. (Providence, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bethany Rallis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bethany Rallis was last updated on August 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.