Provider Demographics
NPI:1588335608
Name:SHIFFLETT, BETHANY J (LCPC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:J
Last Name:SHIFFLETT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 LESLIE LN
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2668
Mailing Address - Country:US
Mailing Address - Phone:240-362-7588
Mailing Address - Fax:240-362-7633
Practice Address - Street 1:10700 LESLIE LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2668
Practice Address - Country:US
Practice Address - Phone:240-362-7588
Practice Address - Fax:240-362-7633
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor