Provider Demographics
NPI:1700215340
Name:BETTENHAUSEN, SHERI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:BETTENHAUSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 REMINGTON WAY APT 2201
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-2285
Mailing Address - Country:US
Mailing Address - Phone:859-338-5780
Mailing Address - Fax:
Practice Address - Street 1:2312 REMINGTON WAY APT 2201
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2285
Practice Address - Country:US
Practice Address - Phone:859-338-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical