MEDICARE: BETHANY GENEISE WILLIAMS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6551	SC

General Provider Information

NPI Number	:	1215528385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY GENEISE WILLIAMS LPC

Provider Business Mailing Address
First Line	:	509 BROAD ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-4758
Country	:	US
Telephone Number	:	803-425-4357
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 BROAD ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-4758
Country	:	US
Telephone Number	:	803-425-4357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	08/07/2023

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