Provider Demographics
NPI:1497928790
Name:DAVEY, BETHANY K (LCSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:K
Last Name:DAVEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10096 W FAIRVIEW AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5004
Mailing Address - Country:US
Mailing Address - Phone:208-908-7882
Mailing Address - Fax:
Practice Address - Street 1:10096 W FAIRVIEW AVE STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5004
Practice Address - Country:US
Practice Address - Phone:208-908-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID88613391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical