Individual
BETHANY MAE KACIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-C, LADCMH-C
Contact information
Practice address
1640 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3497
(918) 708-9009
Mailing address
1640 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3497
(918) 708-9009
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
02/12/2024
Last updated
03/31/2026
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