Ethan Shane Blevins is a Counselor based in Bethel, AK. Ethan Shane Blevins practices in Bethel, AK. The NPI Number for Ethan Shane Blevins is 1164952966 and holds a License No. (Alaska).
The current practice location address for Ethan Shane Blevins is 381 4Th Ave, Bethel, AK and can be reached out via phone at 907-543-2242.
Location: 381 4Th Ave, Bethel, AK, 99559
Provider Profile Details
NPI Number
1164952966
Provider Name
Ethan Shane Blevins
Credential
Provider Entity Type
Individual
Gender
Male
Address
381 4Th Ave, Bethel, AK, 99559
Phone Number
907-543-2242
Fax Number
Provider Enumeration Date
06/14/2017
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | 05 | AR |
Provider Business Practice Location Address Details
Address
381 4Th Ave
City
State
Zip
99559
Phone Number
907-543-2242
Fax Number
Provider Business Mailing Address Details
Address
381 4Th Ave
City
State
Zip
99559
Phone Number
907-543-2242
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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