MEDICARE: DIFFERENT WAY COUNSELING LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1629955372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIFFERENT WAY COUNSELING LLC

Provider Business Mailing Address
First Line	:	500 HUBER PARK CT STE 203
Second Line	:
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-8683
Country	:	US
Telephone Number	:	636-336-8382
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 HUBER PARK CT STE 200
Second Line	:
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-8683
Country	:	US
Telephone Number	:	636-336-8382
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GERALD BETHEL
Credential	:	MS, LPC
Telephone Number	:	636-336-8382

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	01/12/2026

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