Healthcare Provider Details

I. General information

NPI: 1669366100
Provider Name (Legal Business Name): BETHANY BILLY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CHEW ST STE 306
ALLENTOWN PA
18102-3423
US

IV. Provider business mailing address

451 CHEW ST STE 306
ALLENTOWN PA
18102-3423
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-2400
  • Fax: 484-526-3697
Mailing address:
  • Phone: 484-526-2400
  • Fax: 484-526-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW025043
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: