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General NPI Number Information
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NPI Number | 1568320455
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Entity Type | Individual
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Provider Name | QUENTIN BETHEA
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2818 QUEEN CITY DR STE N
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City | CHARLOTTE
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State | NC
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Zip | 28208-2736
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Country | US
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Telephone | 980-349-7095
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Fax |
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Provider Business Mailing Address
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Address Line | 9104 WINTER PARK CT APT 202
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City | CHARLOTTE
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State | NC
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Zip | 28216-2480
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Country | US
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Telephone | 512-299-3627
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Fax | 512-299-3627
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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