Provider Demographics
NPI:1538931860
Name:DICKEN, BETHANY ANN (LCSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:ANN
Last Name:DICKEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4926
Mailing Address - Country:US
Mailing Address - Phone:406-361-5291
Mailing Address - Fax:
Practice Address - Street 1:2755 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4926
Practice Address - Country:US
Practice Address - Phone:406-361-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical