Provider Demographics
NPI:1881641991
Name:MCBETH, LOUISA R (LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISA
Middle Name:R
Last Name:MCBETH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LOUISA
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2723
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-2723
Mailing Address - Country:US
Mailing Address - Phone:252-212-3350
Mailing Address - Fax:252-212-0322
Practice Address - Street 1:90 GUARDIAN CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3017
Practice Address - Country:US
Practice Address - Phone:252-212-3350
Practice Address - Fax:252-212-0322
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0008161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical