Provider Demographics
NPI:1225426547
Name:BETTWY, GRETCHEN (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:BETTWY
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-4527
Mailing Address - Country:US
Mailing Address - Phone:814-312-3685
Mailing Address - Fax:
Practice Address - Street 1:1301 ALLEGHENY ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2455
Practice Address - Country:US
Practice Address - Phone:814-312-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional