Johnson, Bethany Ann

Johnson, Bethany Ann is an sole proprietor health care provider with primary practice located at 2240 Prairie Ave , Beloit WI 53511-2648. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Johnson, Bethany Ann can be contacted via phone (086) 361-7200.

Contact Information

Primary practice address
2240 Prairie Ave Beloit WI 53511-2648
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1144868357
LBN Legal business name Johnson, Bethany Ann
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 18th, 2019
Last updated Feb 9th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144868357 NPPES
Illinois MEDICAID 474579189001

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