Provider Demographics
NPI:1871191478
Name:BETE, LAURETTA (LICSW)
Entity Type:Individual
Prefix:
First Name:LAURETTA
Middle Name:
Last Name:BETE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BETE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:162 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:LEYDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01337-9663
Mailing Address - Country:US
Mailing Address - Phone:413-695-3063
Mailing Address - Fax:413-448-2198
Practice Address - Street 1:162 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:LEYDEN
Practice Address - State:MA
Practice Address - Zip Code:01337-9663
Practice Address - Country:US
Practice Address - Phone:413-695-3063
Practice Address - Fax:413-448-2198
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA1264141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor