Individual
BETHANY BRECKENRIDGE MCELYEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 BROAD STREET, BAINBRIDGE, GA 39817-3614
(229) 416-4737
(229) 416-4738
Mailing address
102 BROAD STREET, BAINBRIDGE, GA 39817-3614
(229) 416-4737
(229) 416-4738
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC002348
GA
101YP2500X
Professional Counselor
Primary
LPC006633
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003194071A
—
GA
Enumeration date
03/22/2010
Last updated
05/23/2023
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