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General NPI Number Information
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NPI Number | 1831914514
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Entity Type | Organization
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Legal Business Name | BETHESDA COUNSELING LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 4200 E STATE HIGHWAY 52
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City | HARTFORD
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State | AL
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Zip | 36344-5122
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Country | US
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Telephone | 334-589-0874
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Fax |
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Provider Business Mailing Address
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Address Line | 491 LEWIS RD
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City | SLOCOMB
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State | AL
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Zip | 36375-5325
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Country | US
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Telephone | 334-589-0874
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Fax | 334-323-5633
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Authorized Official
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Title or Position | OWNER
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Name | AMEE FULFORD
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Credential |
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Telephone | 334-589-0874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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