Individual
BETHANY DERBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1418 SAINT BERNARD AVE, NEW ORLEANS, LA 70116-1417
(814) 853-9005
Mailing address
1418 SAINT BERNARD AVE, NEW ORLEANS, LA 70116-1417
(814) 853-9005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC12022-125
WI
101YP2500X
Professional Counselor
7738
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC12022-125
DSPS
WI
Enumeration date
05/30/2024
Last updated
03/11/2026
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