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General NPI Number Information
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NPI Number | 1982834685
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Entity Type | Organization
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Legal Business Name | BETHEA AND ASSOCIATES, INC.
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 1511 JOHNSON AVE
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City | ELMONT
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State | NY
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Zip | 11003-2318
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Country | US
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Telephone | 347-752-0757
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 JOHNSON AVE
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City | ELMONT
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State | NY
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Zip | 11003-2318
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Country | US
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Telephone | 347-752-0757
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. JAMES STEVEN BETHEA
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Credential | PH.D, LMHC, CRC
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Telephone | 347-752-0757
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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 | 001476
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001476
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001476
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License Number State | NY
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