Provider Demographics
NPI:1679876858
Name:DOLLAR, BETHANY E (LCSW)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:E
Last Name:DOLLAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 SEDGWYCK LN
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7083
Mailing Address - Country:US
Mailing Address - Phone:229-251-1098
Mailing Address - Fax:229-245-9791
Practice Address - Street 1:2704 N OAK ST
Practice Address - Street 2:BUILDING B-3
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1744
Practice Address - Country:US
Practice Address - Phone:229-257-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0043481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical