Provider Demographics
NPI:1558067603
Name:GRAY-HENSON, BETTYANN (MSW, QMHP-C)
Entity Type:Individual
Prefix:
First Name:BETTYANN
Middle Name:
Last Name:GRAY-HENSON
Suffix:
Gender:F
Credentials:MSW, QMHP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 MIDDLE TOWNE CRES
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-4053
Mailing Address - Country:US
Mailing Address - Phone:757-587-5615
Mailing Address - Fax:757-587-5639
Practice Address - Street 1:508 S INDEPENDENCE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1178
Practice Address - Country:US
Practice Address - Phone:757-490-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty