| Bethany Johnson | |
|
606 E Main St Madison IN 47250-4708 | |
| (812) 265-4151 | |
| Not Available |
| Full Name | Bethany Johnson |
|---|---|
| Speciality | Clinic/Center |
| Location | 606 E Main St, Madison, Indiana |
| Authorized Official Name and Position | Bethany Johnson (THERAPIST/OWNER) |
| Authorized Official Contact | 2344445055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Johnson 606 E Main St Ste 2 Madison IN 47250-3689 Ph: (234) 444-5055 | Bethany Johnson 606 E Main St Madison IN 47250-4708 Ph: (812) 265-4151 |
| NPI Number | 1053078832 |
|---|---|
| Provider Enumeration Date | 11/29/2021 |
| Last Update Date | 09/26/2023 |
| Certification Date | 09/26/2023 |
| Medicare PECOS PAC ID | 3971995994 |
|---|---|
| Medicare Enrollment ID | O20220124001910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053078832 | NPI | - | NPPES |
| 1053078832 | Medicaid | IN | |
| 4731973 | Other | AETNA |
| Provider Name | Bethany Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336591668 PECOS PAC ID: 5991133373 Enrollment ID: I20200318000820 |
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