Provider Demographics
NPI:1043401755
Name:BETTROSS, CARLA LOUISE (PCC-S, ATR-BC, PC)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:LOUISE
Last Name:BETTROSS
Suffix:
Gender:F
Credentials:PCC-S, ATR-BC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SHENANGO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1177
Mailing Address - Country:US
Mailing Address - Phone:724-657-1881
Mailing Address - Fax:724-657-9178
Practice Address - Street 1:11 SHENANGO RD STE 1
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1177
Practice Address - Country:US
Practice Address - Phone:724-657-1881
Practice Address - Fax:724-657-9178
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
05-144101Y00000X
OHE.0004279101YP2500X
PAPC004227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor