Provider Demographics
NPI:1356678072
Name:DUFF, BETTY LEW (LPC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:LEW
Last Name:DUFF
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 1:3008 PALEFACE CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-2456
Mailing Address - Country:US
Mailing Address - Phone:512-466-7636
Mailing Address - Fax:512-514-0341
Practice Address - Street 1:3008 PALEFACE CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78734-2456
Practice Address - Country:US
Practice Address - Phone:512-466-7636
Practice Address - Fax:512-514-0341
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional