Provider Demographics
NPI:1972613164
Name:GRISWELL, BETTY KAREN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:KAREN
Last Name:GRISWELL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-5501
Mailing Address - Country:US
Mailing Address - Phone:817-774-2696
Mailing Address - Fax:817-774-2691
Practice Address - Street 1:115 S MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5501
Practice Address - Country:US
Practice Address - Phone:817-774-2696
Practice Address - Fax:817-774-2691
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177034901Medicaid