Individual
BETHANEY DENISE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
909 S MAIN ST, MARION, KY 42064-1923
(270) 704-4131
Mailing address
130 CIRCLE DR, MARION, KY 42064-1259
(270) 704-9133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
256550
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100802110
—
KY
Enumeration date
03/07/2007
Last updated
05/15/2025
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