Provider Demographics
NPI:1376885004
Name:BETTS, EILEEN C (LMHC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:C
Last Name:BETTS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PLANT RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4315
Mailing Address - Country:US
Mailing Address - Phone:518-373-1984
Mailing Address - Fax:
Practice Address - Street 1:206 GLEN ST STE 32
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3585
Practice Address - Country:US
Practice Address - Phone:518-223-0784
Practice Address - Fax:518-615-1272
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002987-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health