Provider Demographics
NPI:1689361248
Name:SHAY, BETHANY LEANORA (MSW)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LEANORA
Last Name:SHAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 OLDEN OAK LN APT 201
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2161
Mailing Address - Country:US
Mailing Address - Phone:231-233-8208
Mailing Address - Fax:
Practice Address - Street 1:15600 19 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-3502
Practice Address - Country:US
Practice Address - Phone:586-263-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator