Provider Demographics
NPI:1720456502
Name:EARNEST, BETHANY (LPC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:EARNEST
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 1:1940 HIGHWAY 33
Mailing Address - Street 2:UNIT A
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4886
Mailing Address - Country:US
Mailing Address - Phone:205-664-4010
Mailing Address - Fax:
Practice Address - Street 1:1940 HIGHWAY 33
Practice Address - Street 2:UNIT A
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4886
Practice Address - Country:US
Practice Address - Phone:205-664-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3336101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor