Provider Demographics
NPI:1164758736
Name:BROWN, BETHANY LARIMORE (LPCC-S)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LARIMORE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:LEANNE
Other - Last Name:LARIMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1002 N MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2037
Mailing Address - Country:US
Mailing Address - Phone:270-495-3370
Mailing Address - Fax:
Practice Address - Street 1:1002 N MULBERRY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2037
Practice Address - Country:US
Practice Address - Phone:270-982-9292
Practice Address - Fax:270-982-9293
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0939101YP2500X
KY1053935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100274580Medicaid