Provider Demographics
NPI:1497039960
Name:LEBOW, BETSEY L (LMFT)
Entity Type:Individual
Prefix:
First Name:BETSEY
Middle Name:L
Last Name:LEBOW
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TURKEY HILL RD S # 203
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5525
Mailing Address - Country:US
Mailing Address - Phone:203-216-1999
Mailing Address - Fax:
Practice Address - Street 1:1 TURKEY HILL RD S # 203
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5525
Practice Address - Country:US
Practice Address - Phone:203-216-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist