Provider Demographics
NPI:1245241397
Name:WARDEN, BETTY J (LCSW)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:J
Last Name:WARDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3825
Mailing Address - Country:US
Mailing Address - Phone:541-383-2004
Mailing Address - Fax:541-322-4760
Practice Address - Street 1:2052 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3825
Practice Address - Country:US
Practice Address - Phone:541-383-2004
Practice Address - Fax:541-322-4760
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL37851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical