Provider Demographics
NPI:1790098754
Name:PACHECO, BETHANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:BETHANIE
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETHANIE
Other - Middle Name:
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2967 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:PIFFARD
Mailing Address - State:NY
Mailing Address - Zip Code:14533-9702
Mailing Address - Country:US
Mailing Address - Phone:585-315-1874
Mailing Address - Fax:
Practice Address - Street 1:7706 13TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2414
Practice Address - Country:US
Practice Address - Phone:718-313-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)