Provider Demographics
NPI:1922723311
Name:MITTELMAN, BETHANY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:MITTELMAN
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 1:1848 TILTON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2663
Mailing Address - Country:US
Mailing Address - Phone:412-616-9064
Mailing Address - Fax:
Practice Address - Street 1:323 S FAIRMOUNT ST APT 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1076
Practice Address - Country:US
Practice Address - Phone:412-616-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014894101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional