Provider Demographics
NPI:1043586233
Name:CAIN, BETH ELLEN (LCSWR)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ELLEN
Last Name:CAIN
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ELLEN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWR
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-547-1105
Mailing Address - Fax:607-547-1093
Practice Address - Street 1:39 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1410
Practice Address - Country:US
Practice Address - Phone:607-547-1105
Practice Address - Fax:607-547-1093
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2012-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73-0519171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical