Provider Demographics
NPI:1497282131
Name:LADDIN, BETH
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:LADDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 HIGHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THOMAS O'BRIEN ACADEMY OF SCIENCE AND TECHNOLOGY SCHOOL
Practice Address - Street 2:LINCOLN PARK/ DELAWARE AVE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202
Practice Address - Country:US
Practice Address - Phone:518-475-6888
Practice Address - Fax:518-475-6877
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0661861041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool