Provider Demographics
NPI:1376171835
Name:JOHNSON, BETHANY NOEL (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:NOEL
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6599 STATE ROUTE 314
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813-9567
Mailing Address - Country:US
Mailing Address - Phone:419-560-0387
Mailing Address - Fax:
Practice Address - Street 1:231 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904-1353
Practice Address - Country:US
Practice Address - Phone:419-520-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health