# MR. SAMUEL BETHEL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1083019913
- **Gender:** Man
- **Credential:** MSW, LCSW, LISW-CP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 12619 | SC | Yes |
| 1041C0700X | Clinical Social Worker | 2013035402 | MO | — |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 08/01/2022