Provider Demographics
NPI:1356937155
Name:CRILE, BETHANY MARIE (LPC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIE
Last Name:CRILE
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 1:1001 E 17TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1437
Mailing Address - Country:US
Mailing Address - Phone:724-825-1309
Mailing Address - Fax:
Practice Address - Street 1:789 N SHERMAN ST STE 440
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3531
Practice Address - Country:US
Practice Address - Phone:720-314-7378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012860101YP2500X
COLPC.0017124101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional