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General NPI Number Information
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NPI Number | 1285859751
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Entity Type | Organization
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Legal Business Name | BETHEL CENTER FOR PSYCHOTHERAPY
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 213 W WESLEY ST SUITE 204
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City | WHEATON
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State | IL
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Zip | 60187-5135
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Country | US
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Telephone | 630-681-1900
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Fax | 630-462-7669
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Provider Business Mailing Address
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Address Line | 213 W WESLEY ST SUITE 204
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City | WHEATON
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State | IL
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Zip | 60187-5135
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Country | US
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Telephone | 630-681-1900
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Fax | 630-462-7669
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Authorized Official
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Title or Position | CLINICAL DIRECTOR CLINICAL PSYCHOL
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Name | DR. BETTY ANNE RILEY
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Credential | PSY.D.
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Telephone | 630-681-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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