Provider Demographics
NPI:1679244974
Name:WELC, BETHANY ANNE (LLMSW)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:ANNE
Last Name:WELC
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:ANNE
Other - Last Name:MEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 THORNEHILL TRL
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-5106
Mailing Address - Country:US
Mailing Address - Phone:248-933-0432
Mailing Address - Fax:
Practice Address - Street 1:925 N LAPEER RD STE 151
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6742
Practice Address - Country:US
Practice Address - Phone:248-800-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-26
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011087811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical