Healthcare Provider Details

I. General information

NPI: 1821680372
Provider Name (Legal Business Name): BETHANY LYNN ALBAUGH APRN,PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N WALNUT ST
DOVER OH
44622-2850
US

IV. Provider business mailing address

130 W 3RD ST
DOVER OH
44622-2934
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-6600
  • Fax: 330-343-6405
Mailing address:
  • Phone: 330-343-6600
  • Fax: 330-343-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.290526
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN.290526
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0040080
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: