Provider Demographics
NPI:1730458589
Name:BETTS, CICELY MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CICELY
Middle Name:MARIE
Last Name:BETTS
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 1:11900 SHADOW CREEK PKWY
Mailing Address - Street 2:APT 122
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4821
Mailing Address - Country:US
Mailing Address - Phone:832-567-5376
Mailing Address - Fax:
Practice Address - Street 1:11900 SHADOW CREEK PKWY
Practice Address - Street 2:APT 122
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4821
Practice Address - Country:US
Practice Address - Phone:832-567-5376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
000000000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker