Provider Demographics
NPI:1821868118
Name:PUENTES, BETSY BOUTON (LPC-S, LPA-IP, LMFT)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:BOUTON
Last Name:PUENTES
Suffix:
Gender:F
Credentials:LPC-S, LPA-IP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-1734
Mailing Address - Country:US
Mailing Address - Phone:210-410-5715
Mailing Address - Fax:
Practice Address - Street 1:102 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-1734
Practice Address - Country:US
Practice Address - Phone:210-410-5715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3948101Y00000X
TX3690101YA0400X
TX4607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)