Provider Demographics
NPI:1780736074
Name:HADLEY, BETHANY S (LICSW)
Entity type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:S
Last Name:HADLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:BETHANY
Other - Middle Name:M
Other - Last Name:SPENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 SW CUTOFF
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2135
Mailing Address - Country:US
Mailing Address - Phone:508-397-9586
Mailing Address - Fax:208-460-0971
Practice Address - Street 1:21 SW CUTOFF
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2135
Practice Address - Country:US
Practice Address - Phone:508-397-9586
Practice Address - Fax:208-460-0971
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1101381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical