Provider Demographics
NPI:1538873518
Name:MONSEN, BETHANIE (NCSP)
Entity type:Individual
Prefix:
First Name:BETHANIE
Middle Name:
Last Name:MONSEN
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-3521
Mailing Address - Country:US
Mailing Address - Phone:801-979-1357
Mailing Address - Fax:
Practice Address - Street 1:45 E STATE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2344
Practice Address - Country:US
Practice Address - Phone:801-402-5134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool