Provider Demographics
NPI:1467846626
Name:CALDWELL, BETHANY ANN (MSCP, LPC, CBIS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:ANN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MSCP, LPC, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2527
Mailing Address - Country:US
Mailing Address - Phone:470-223-2256
Mailing Address - Fax:
Practice Address - Street 1:4431 WILLIAM PENN HWY STE 5
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1946
Practice Address - Country:US
Practice Address - Phone:470-223-2256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005326101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)