Provider Demographics
NPI:1629363726
Name:BETANCOURTH, MARIA D (MS, LPCC, PPS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:BETANCOURTH
Suffix:
Gender:F
Credentials:MS, LPCC, PPS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:D
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC, PPS
Mailing Address - Street 1:33303 GYPSUM ST
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7621
Mailing Address - Country:US
Mailing Address - Phone:509-840-9613
Mailing Address - Fax:
Practice Address - Street 1:210 W. SPRAGUE AVE.
Practice Address - Street 2:LUTHERAN COMMUNITY SERVICES (INTERN CLINICIAN)
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3816
Practice Address - Country:US
Practice Address - Phone:509-747-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220071940101YS0200X
CALPCC9668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool