Provider Demographics
NPI:1669002374
Name:GALEY, BETHANY LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNNE
Last Name:GALEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MUDFORT DR
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-6353
Mailing Address - Country:US
Mailing Address - Phone:717-658-3638
Mailing Address - Fax:
Practice Address - Street 1:150 E BURR BLVD
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-4793
Practice Address - Country:US
Practice Address - Phone:681-252-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional