Healthcare Provider Details

I. General information

NPI: 1164758736
Provider Name (Legal Business Name): BETHANY LARIMORE BROWN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETHANY LEANNE LARIMORE

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 01/08/2025
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E MAIN ST
CECILIA KY
42724-7614
US

IV. Provider business mailing address

P.O. BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 844-435-0900
  • Fax: 270-858-4029
Mailing address:
  • Phone: 270-864-1472
  • Fax: 270-864-1693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberKY-0939
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1053935
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number105393
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: