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Individual
BRIAN L BETHEL
Active
Individual
BRIAN L BETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCC LCDCIII
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E4376
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
991594
OH
101YP2500X
Professional Counselor
E4376
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315699
ANTHEM
OH
Enumeration date
06/26/2006
Last updated
05/07/2008
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