Provider Demographics
NPI:1093356859
Name:CORNELIO, BETCHIE CLAIRE (LMHC)
Entity Type:Individual
Prefix:
First Name:BETCHIE CLAIRE
Middle Name:
Last Name:CORNELIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:CORNELIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:276 5TH AVE RM 704
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4527
Mailing Address - Country:US
Mailing Address - Phone:330-356-8315
Mailing Address - Fax:
Practice Address - Street 1:276 5TH AVE RM 704
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4527
Practice Address - Country:US
Practice Address - Phone:330-356-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011301101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health