Provider Demographics
NPI:1023836681
Name:ZEKVELD, BETHANY MICHELE (M ED, EDS, NCSP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MICHELE
Last Name:ZEKVELD
Suffix:
Gender:F
Credentials:M ED, EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 N POST RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-5545
Mailing Address - Country:US
Mailing Address - Phone:317-869-4300
Mailing Address - Fax:
Practice Address - Street 1:975 N POST RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-5545
Practice Address - Country:US
Practice Address - Phone:317-869-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1609579103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool