Provider Demographics
NPI:1558135954
Name:BETHUNE, JENNIFER (LMHCA, MA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BETHUNE
Suffix:
Gender:F
Credentials:LMHCA, MA
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:MONETTE-BETHUNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHCA, MA
Mailing Address - Street 1:13708 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3922
Mailing Address - Country:US
Mailing Address - Phone:253-267-2846
Mailing Address - Fax:
Practice Address - Street 1:13708 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-3922
Practice Address - Country:US
Practice Address - Phone:253-267-2846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61477682101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor