Provider Demographics
NPI:1114704574
Name:MCRAE, BETHANY HOPE (MS)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:HOPE
Last Name:MCRAE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:BETHANY
Other - Middle Name:HOPE
Other - Last Name:VANVEKOVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6510 S WESTERN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1712
Mailing Address - Country:US
Mailing Address - Phone:405-634-1497
Mailing Address - Fax:
Practice Address - Street 1:6510 S WESTERN AVE STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1712
Practice Address - Country:US
Practice Address - Phone:405-634-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)