Provider Demographics
NPI:1689201618
Name:WINFIELD, BETHANY ELISE (MA)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:ELISE
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9383 OLD HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:BON AQUA
Mailing Address - State:TN
Mailing Address - Zip Code:37025-1763
Mailing Address - Country:US
Mailing Address - Phone:850-294-5385
Mailing Address - Fax:
Practice Address - Street 1:805 BRADFORD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2105
Practice Address - Country:US
Practice Address - Phone:615-682-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1542101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor