Provider Demographics
NPI:1851360481
Name:HAGUE HAMBY, BETHANEY L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BETHANEY
Middle Name:L
Last Name:HAGUE HAMBY
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 1:316 RONDA CLINGMAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:RONDA
Mailing Address - State:NC
Mailing Address - Zip Code:28670-8817
Mailing Address - Country:US
Mailing Address - Phone:336-984-2200
Mailing Address - Fax:336-984-3210
Practice Address - Street 1:316 RONDA CLINGMAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:RONDA
Practice Address - State:NC
Practice Address - Zip Code:28670-8817
Practice Address - Country:US
Practice Address - Phone:336-984-2200
Practice Address - Fax:336-984-3210
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4910101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1402MOtherBCBS OF NC
NC6103038Medicaid
NCN/AOtherCAROLINA BEHAVIORAL HEALT