Provider Demographics
NPI:1619009495
Name:TAYLOR, BETSY (MA, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 COURT ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3409
Mailing Address - Country:US
Mailing Address - Phone:603-357-2357
Mailing Address - Fax:
Practice Address - Street 1:81 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3409
Practice Address - Country:US
Practice Address - Phone:603-357-2357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1409437 Y0NH01OtherANTHEM
NH30011474Medicaid