Provider Demographics
NPI:1710492889
Name:SCHLUETER-BRANNAM, BETSY W (LCSW)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:W
Last Name:SCHLUETER-BRANNAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:W
Other - Last Name:SCHLUETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:14 EAGLE CREST LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3742
Mailing Address - Country:US
Mailing Address - Phone:314-313-0898
Mailing Address - Fax:
Practice Address - Street 1:14 EAGLE CREST LN
Practice Address - Street 2:
Practice Address - City:ST. CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3742
Practice Address - Country:US
Practice Address - Phone:314-313-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0013671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty