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NPI Code Detail

MEDICARE: MRS. BETHANY J VUKUSIC LMSW

MEDICARE:  MRS. BETHANY J VUKUSIC  LMSW
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
1374J00000XDoula
21041C0700XClinical Social Worker6801093529MI

General Provider Information

NPI Number : 1245501931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETHANY J VUKUSIC LMSW
Provider Business Mailing Address
First Line : 15167 BRIARWOOD ST
Second Line :
City : GRAND HAVEN
State : MI
Zip : 49417-9194
Country : US
Telephone Number : 616-990-3590
Fax Number :
Provider Business Practice Location Address
First Line : 15167 BRIARWOOD ST
Second Line :
City : GRAND HAVEN
State : MI
Zip : 49417-9194
Country : US
Telephone Number : 616-990-3590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2012
Last Update Date : 04/16/2025

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Directions to “ MRS. BETHANY J VUKUSIC LMSW” Practice Location

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