Provider Demographics
NPI:1275328197
Name:BETHEA, CE'MONE ALEXUS (RBT)
Entity type:Individual
Prefix:
First Name:CE'MONE
Middle Name:ALEXUS
Last Name:BETHEA
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 WESTCHASE VILLAGE LN APT F
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4711
Mailing Address - Country:US
Mailing Address - Phone:404-996-8115
Mailing Address - Fax:
Practice Address - Street 1:3190 NORTHEAST EXPY NE STE 110
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-5323
Practice Address - Country:US
Practice Address - Phone:404-487-6005
Practice Address - Fax:678-831-3005
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-19-109193106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician