Provider Demographics
NPI:1881267284
Name:HAGOPIAN, BETHANY A (LCMHC, NCC, MS)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:A
Last Name:HAGOPIAN
Suffix:
Gender:F
Credentials:LCMHC, NCC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1669
Mailing Address - Country:US
Mailing Address - Phone:336-907-7308
Mailing Address - Fax:336-907-7309
Practice Address - Street 1:300 S WESTGATE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1669
Practice Address - Country:US
Practice Address - Phone:336-907-7308
Practice Address - Fax:336-907-7309
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional