Provider Demographics
NPI:1598928673
Name:LAWSON, BETHAMI L
Entity Type:Individual
Prefix:MS
First Name:BETHAMI
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BETHAMI
Other - Middle Name:L
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 57742
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413-2742
Mailing Address - Country:US
Mailing Address - Phone:818-885-8500
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:SUITE 603
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:818-885-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 297071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical