Provider Demographics
NPI:1962851535
Name:BETTERS, TERRA
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:BETTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERRA
Other - Middle Name:MARIE
Other - Last Name:BETTERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:819 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-1623
Mailing Address - Country:US
Mailing Address - Phone:724-216-8984
Mailing Address - Fax:
Practice Address - Street 1:819 JEFFERSON STEET
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132
Practice Address - Country:US
Practice Address - Phone:724-216-8984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265EMedicaid