Provider Demographics
NPI:1114074325
Name:BETANCES, ANGELA R (LPC, LCADC, MA,PHD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:R
Last Name:BETANCES
Suffix:
Gender:F
Credentials:LPC, LCADC, MA,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-1954
Mailing Address - Country:US
Mailing Address - Phone:856-768-1101
Mailing Address - Fax:856-768-1100
Practice Address - Street 1:368 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-1954
Practice Address - Country:US
Practice Address - Phone:856-768-1101
Practice Address - Fax:856-768-1100
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00085600101YA0400X
NJ37PC00140100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)