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Individual
MISS JENNIFER T BETHEA
Active
Individual
MISS JENNIFER T BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1672
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
008022626
—
CT
05
—
008056168
—
CT
05
—
008144778
—
CT
05
—
500000315
—
CT
Enumeration date
02/16/2017
Last updated
06/25/2026
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