Provider Demographics
NPI:1568921906
Name:LOCKERMAN, BETHANY LEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LEE
Last Name:LOCKERMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:LEE
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1104 SHELDON DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-4324
Mailing Address - Country:US
Mailing Address - Phone:302-540-5816
Mailing Address - Fax:
Practice Address - Street 1:1104 SHELDON DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4324
Practice Address - Country:US
Practice Address - Phone:302-540-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011379101YP2500X
PAPC011055101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional