Provider Demographics
NPI:1053198150
Name:SPICHER, BETHANY (MA, LGPC)
Entity type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:
Last Name:SPICHER
Suffix:
Gender:F
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 MOSSY STONE CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1077
Mailing Address - Country:US
Mailing Address - Phone:301-741-9998
Mailing Address - Fax:
Practice Address - Street 1:8217 MOSSY STONE CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1077
Practice Address - Country:US
Practice Address - Phone:301-741-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health