Teresa Wilburn Bethany, LMFT

Individual provider Active NPI Mental Health Counselor · Universal City, TX

NPI 1790403202 · NPPES record last updated Aug 19, 2022

Key facts

NPI
1790403202
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
202850 (TX)
Practice address
109 Splitrock LN
Universal City, TX 78148-5521
Phone
(210) 392-5827
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
Yes

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
202850TXMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 202850 TX Yes

Addresses

Primary practice location

109 Splitrock LN
Universal City, TX 78148-5521

Mailing address

109 Splitrock LN
Universal City, TX 78148-5521
Phone (210) 392-5827

Other providers in Universal City, TX

All providers in Universal City, TX · Mental Health Counselor in Texas

Sources for this page

Verify at the official NPI Registry.