Provider Demographics
NPI:1457950610
Name:BEKELE, BETHELHEM (RN, BSN, MSN PMHNP)
Entity type:Individual
Prefix:
First Name:BETHELHEM
Middle Name:
Last Name:BEKELE
Suffix:
Gender:
Credentials:RN, BSN, MSN PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12011 GOVERNMENT CENTER PKWY STE 836
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22035-1100
Mailing Address - Country:US
Mailing Address - Phone:703-246-4454
Mailing Address - Fax:
Practice Address - Street 1:200 N GLEBE RD STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3755
Practice Address - Country:US
Practice Address - Phone:703-841-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001302945163W00000X
VA0024188749363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse