Provider Demographics
NPI:1376725390
Name:BETHMARK INC
Entity type:Organization
Organization Name:BETHMARK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, PHD
Authorized Official - Phone:956-421-2727
Mailing Address - Street 1:PO BOX 2127
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-2127
Mailing Address - Country:US
Mailing Address - Phone:956-421-2727
Mailing Address - Fax:
Practice Address - Street 1:722 MORGAN BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5139
Practice Address - Country:US
Practice Address - Phone:956-421-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC12751101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty