Provider Demographics
NPI:1265270771
Name:MCNEW, BETHANY NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:NICOLE
Last Name:MCNEW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 QUALITY LN
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2237
Mailing Address - Country:US
Mailing Address - Phone:417-207-5006
Mailing Address - Fax:
Practice Address - Street 1:110 N ELM AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-2418
Practice Address - Country:US
Practice Address - Phone:314-961-5718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240286171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical