Provider Demographics
NPI:1073858882
Name:EMBRY, BETH (LCSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:EMBRY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 WASHINGTON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4861
Mailing Address - Country:US
Mailing Address - Phone:812-455-0233
Mailing Address - Fax:812-909-9240
Practice Address - Street 1:5011 WASHINGTON AVE STE 4
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4861
Practice Address - Country:US
Practice Address - Phone:812-455-0233
Practice Address - Fax:812-909-9240
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007210A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical