Provider Demographics
NPI:1790076958
Name:PHELPS, BETHANY DORCAS (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:DORCAS
Last Name:PHELPS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BURKEMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4454
Mailing Address - Country:US
Mailing Address - Phone:828-433-5600
Mailing Address - Fax:828-433-5656
Practice Address - Street 1:220 BURKEMONT AVENUE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4454
Practice Address - Country:US
Practice Address - Phone:828-433-5600
Practice Address - Fax:828-433-5656
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health