Provider Demographics
NPI:1982834685
Name:BETHEA AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:BETHEA AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BETHEA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC, CRC
Authorized Official - Phone:347-752-0757
Mailing Address - Street 1:1511 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2318
Mailing Address - Country:US
Mailing Address - Phone:347-752-0757
Mailing Address - Fax:
Practice Address - Street 1:1511 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2318
Practice Address - Country:US
Practice Address - Phone:347-752-0757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001476251B00000X, 251E00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health