Provider Demographics
NPI:1689971202
Name:ARMSTRONG, BETHANY JADE (LPC)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:JADE
Last Name:ARMSTRONG
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 1:1471 DEWAR DR STE 209
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5826
Mailing Address - Country:US
Mailing Address - Phone:307-352-9161
Mailing Address - Fax:
Practice Address - Street 1:1471 DEWAR DR STE 209
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5826
Practice Address - Country:US
Practice Address - Phone:307-352-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0014314101YM0800X
WYLPC-1590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health