Provider Demographics
NPI:1285292839
Name:HEATH, BETHANY DAWN
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:DAWN
Last Name:HEATH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5196 RAMPART RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4967
Mailing Address - Country:US
Mailing Address - Phone:614-323-9721
Mailing Address - Fax:
Practice Address - Street 1:5300 E MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2580
Practice Address - Country:US
Practice Address - Phone:330-928-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker