Provider Demographics
NPI:1083986582
Name:BELTRAN, ESABEL T (LMHC)
Entity Type:Individual
Prefix:
First Name:ESABEL
Middle Name:T
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MARYLYN
Other - Middle Name:ELIZABETH
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-0212
Mailing Address - Country:US
Mailing Address - Phone:509-731-2500
Mailing Address - Fax:509-249-0035
Practice Address - Street 1:1450 N 16TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1381
Practice Address - Country:US
Practice Address - Phone:509-731-2500
Practice Address - Fax:509-249-0035
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00008736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health