Provider Demographics
NPI:1154311637
Name:WROBLEWSKI, BETSY (LCSW, CAC III)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:
Last Name:WROBLEWSKI
Suffix:
Gender:F
Credentials:LCSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 3RD AVE RM 205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3679
Mailing Address - Country:US
Mailing Address - Phone:808-753-5483
Mailing Address - Fax:
Practice Address - Street 1:1651 3RD AVE
Practice Address - Street 2:RM 205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3679
Practice Address - Country:US
Practice Address - Phone:808-753-5483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5510101YA0400X
CO9928761041C0700X
NY0817941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)