Provider Demographics
NPI:1902470776
Name:BETHANY PONICHTER LMSW PLLC
Entity Type:Organization
Organization Name:BETHANY PONICHTER LMSW PLLC
Other - Org Name:BE SOUND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PONICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-418-9180
Mailing Address - Street 1:2860 SEMINOLE RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1329
Mailing Address - Country:US
Mailing Address - Phone:248-259-8540
Mailing Address - Fax:
Practice Address - Street 1:343 S MAIN ST STE 209B
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2137
Practice Address - Country:US
Practice Address - Phone:734-418-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty