Provider Demographics
NPI:1144910340
Name:TRAYNHAM, BETHANY (MSSW, CSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:TRAYNHAM
Suffix:
Gender:F
Credentials:MSSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 KENTUCKY BLUE CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4719
Mailing Address - Country:US
Mailing Address - Phone:502-702-1862
Mailing Address - Fax:
Practice Address - Street 1:362 KENTUCKY BLUE CIR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4719
Practice Address - Country:US
Practice Address - Phone:502-702-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY256572104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker