Provider Demographics
NPI:1922635002
Name:LAPORTE, BETH ANN (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:BETH
Middle Name:ANN
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:2621 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-6216
Mailing Address - Country:US
Mailing Address - Phone:315-717-2083
Mailing Address - Fax:
Practice Address - Street 1:DRN COUNSELING & CONSULTING SERVICES
Practice Address - Street 2:2621 GENESEE STREET
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-507-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084260104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker