Bethany Canny, CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ottumwa, IA

NPI 1477043099 · NPPES record last updated May 18, 2018

Key facts

NPI
1477043099
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
18022 (IA)
Practice address
310 W. Main St
Ottumwa, IA 52501
Phone
(641) 683-6747
Fax
(641) 683-6317
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18022IAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
United Community Services, Inc. Past Accepting new patients
Southern Iowa Economic Development Assoc Addiction (Substance Use Disorder) Past
since Sep 24, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18022 IA Yes

Addresses

Primary practice location

310 W. Main St
Ottumwa, IA 52501

Mailing address

PO Box 658
Ottumwa, IA 52501
Phone (641) 683-6747

Other names

  • Bethany Roush Former name

Other providers in Ottumwa, IA

All providers in Ottumwa, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.