Provider Demographics
NPI:1558178277
Name:BETH STEVENS COUNSELING LLC
Entity type:Organization
Organization Name:BETH STEVENS COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-280-8113
Mailing Address - Street 1:272 STREAM RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-1735
Mailing Address - Country:US
Mailing Address - Phone:479-280-8113
Mailing Address - Fax:479-431-5014
Practice Address - Street 1:109 S LAREDO AVE
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-4853
Practice Address - Country:US
Practice Address - Phone:479-280-8113
Practice Address - Fax:479-431-5014
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH STEVENS COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-16
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty