Provider Demographics
NPI:1619540085
Name:BROBSON, BETHANY REBEKAH (OCPS, CDCA)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:REBEKAH
Last Name:BROBSON
Suffix:
Gender:F
Credentials:OCPS, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-2136
Mailing Address - Country:US
Mailing Address - Phone:330-253-8803
Mailing Address - Fax:330-253-5992
Practice Address - Street 1:834 GRANT ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-2136
Practice Address - Country:US
Practice Address - Phone:330-253-8803
Practice Address - Fax:330-253-5992
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179183101YA0400X
OH0002138175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist