Provider Demographics
NPI:1043780414
Name:THOMPSON, BETHANY HOPE (MED, LBA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:HOPE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MED, LBA, BCBA
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:LITZENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:9930 KINCEY AVE STE 140
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6541
Practice Address - Country:US
Practice Address - Phone:980-380-9775
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-16766103K00000X
IN1-14-16766103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst