Provider Demographics
NPI:1699192880
Name:KULP, BETHANY ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:ANNE
Last Name:KULP
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 1:326 N LBJ DR STE 190
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5624
Mailing Address - Country:US
Mailing Address - Phone:512-881-7768
Mailing Address - Fax:
Practice Address - Street 1:326 N LBJ DR STE 190
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5624
Practice Address - Country:US
Practice Address - Phone:512-881-7768
Practice Address - Fax:512-265-9627
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000077251041C0700X
TX582421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical