Provider Demographics
NPI:1871106989
Name:BETHUNE, ANNE MARI (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARI
Last Name:BETHUNE
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 1:1260 W 59TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-1149
Mailing Address - Country:US
Mailing Address - Phone:816-588-3515
Mailing Address - Fax:
Practice Address - Street 1:1260 W 59TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-1149
Practice Address - Country:US
Practice Address - Phone:816-588-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical