Provider Demographics
NPI:1932319001
Name:DOREY, BETHANY J (LICSW)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:J
Last Name:DOREY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S WORTHEN ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3081
Mailing Address - Country:US
Mailing Address - Phone:609-662-7105
Mailing Address - Fax:509-663-3182
Practice Address - Street 1:145 S WORTHEN ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3081
Practice Address - Country:US
Practice Address - Phone:509-662-7105
Practice Address - Fax:509-663-3182
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291031041C0700X
WALW607468081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5215OtherREDLANDS-YUCAIPA GUIDANCE CENTERS
WA2090437Medicaid