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General NPI Number Information
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NPI Number | 1689122582
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Entity Type | Individual
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Provider Name | BETHANY CHRISTIAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 11/03/2024
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Provider Practice Location Address
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Address Line | 1030 MONARCH ST STE 100
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City | LEXINGTON
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State | KY
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Zip | 40513-1843
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Country | US
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Telephone | 859-368-0609
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 MONARCH ST STE 100
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City | LEXINGTON
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State | KY
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Zip | 40513-1843
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Country | US
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Telephone | 859-368-0609
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 166495
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 170917
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License Number State | KY
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