Provider Demographics
NPI:1598334146
Name:BETHELMY, JOEL C
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:C
Last Name:BETHELMY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 DRESSER CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7323
Mailing Address - Country:US
Mailing Address - Phone:919-514-3566
Mailing Address - Fax:
Practice Address - Street 1:1011 DRESSER CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7323
Practice Address - Country:US
Practice Address - Phone:919-514-3566
Practice Address - Fax:919-516-0057
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical