Healthcare Provider Details
I. General information
NPI: 1497910046
Provider Name (Legal Business Name): BETH A BRYANT LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/23/2008
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3147 GLENDALE MILFORD RD
CINCINNATI OH
45241-3134
US
IV. Provider business mailing address
3147 GLENDALE MILFORD RD
CINCINNATI OH
45241-3134
US
V. Phone/Fax
- Phone: 513-346-1270
- Fax: 513-346-1270
- Phone: 513-346-1270
- Fax: 513-346-1270
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | E.1700429-SUPV |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: