Individual ProviderBethany WilsonCounselorBehavioral Health & Social Service ProvidersPractice Address7459 Burlington Pike, Florence, KY 41042-1553(859) 578-3200PECOS EnrollmentBased on the most recent information from CMS, provider Bethany Wilson is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1417324278Provider TypeIndividualFull NameWilson, BethanyCredentialLPCCGenderFemaleSole ProprietorNoEnumeration Date8/27/2015Last Updated11/16/2021Contact InformationPractice LocationPractice Address7459 Burlington Pike, Florence, KY 41042-1553Phone(859) 578-3200FaxUnlisted FaxMailing LocationMailing Address503 Farrell Dr, Covington, KY 41011-3775Phone(859) 578-3200Fax(859) 578-3242Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense246875KentuckyProvider IdentifiersIDDescriptionIssuerID610661458DescriptionOtherIssuerTAX IDKentucky