Provider Demographics
NPI:1427730530
Name:REAS, BETHANN (LPC)
Entity type:Individual
Prefix:
First Name:BETHANN
Middle Name:
Last Name:REAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4099
Mailing Address - Country:US
Mailing Address - Phone:715-550-8206
Mailing Address - Fax:
Practice Address - Street 1:444 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4099
Practice Address - Country:US
Practice Address - Phone:715-550-8206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10463-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor