Provider Demographics
NPI:1740392836
Name:BETHEA, ROBIN SHELTON (MS LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SHELTON
Last Name:BETHEA
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5926
Mailing Address - Country:US
Mailing Address - Phone:855-695-7637
Mailing Address - Fax:
Practice Address - Street 1:2528 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5926
Practice Address - Country:US
Practice Address - Phone:855-695-7637
Practice Address - Fax:855-695-7637
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3343Medicare ID - Type Unspecified
SC3343Medicare ID - Type Unspecified