Individual
BETHANY INEZ FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC, CSW
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Mailing address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
265754
KY
1041C0700X
Clinical Social Worker
252973
KY
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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