Organization
BETHANY GENTRY COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY GENTRY LCSW (OWNER)
(704) 929-9751
Entity
Organization
Contact information
Practice address
719A GREENWAY RD, BOONE, NC 28607-4816
(704) 929-9751
Mailing address
7849 NC HIGHWAY 194 S, BANNER ELK, NC 28604-9412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C010968
LCSW
NC
Enumeration date
08/12/2019
Last updated
11/15/2019
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