Provider Demographics
NPI:1245740877
Name:DOHERTY, BETH WAY (LPC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:WAY
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:L
Other - Last Name:WAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:166 BUNN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2800
Mailing Address - Country:US
Mailing Address - Phone:094-779-3336
Mailing Address - Fax:
Practice Address - Street 1:166 BUNN DR STE 102
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2800
Practice Address - Country:US
Practice Address - Phone:094-779-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor