Provider Demographics
NPI:1619472370
Name:MCDOWELL, BETH
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 GIDNEY AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2805
Mailing Address - Country:US
Mailing Address - Phone:845-569-2900
Mailing Address - Fax:866-619-5710
Practice Address - Street 1:633 GIDNEY AVE STE 6
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2805
Practice Address - Country:US
Practice Address - Phone:845-569-2900
Practice Address - Fax:866-619-5710
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005868-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115868-1OtherLICENSE