Provider Demographics
NPI:1295864254
Name:SEBRING, BETTY (LPC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:SEBRING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 LONGFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8055
Mailing Address - Country:US
Mailing Address - Phone:334-288-9009
Mailing Address - Fax:334-288-9497
Practice Address - Street 1:1040 LONGFIELD CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8055
Practice Address - Country:US
Practice Address - Phone:334-288-9009
Practice Address - Fax:334-288-9497
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
274101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL139193000OtherOWCP PROVIDER NUMBER
AL139193000OtherOWCP PROVIDER NUMBER