Provider Demographics
NPI:1265707103
Name:SMITH, BETSY REDD (MA LPC)
Entity type:Individual
Prefix:MS
First Name:BETSY
Middle Name:REDD
Last Name:SMITH
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:PO BOX 1175
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75949-1175
Mailing Address - Country:US
Mailing Address - Phone:936-854-2857
Mailing Address - Fax:
Practice Address - Street 1:1202 FM 1669
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:TX
Practice Address - Zip Code:75949-2918
Practice Address - Country:US
Practice Address - Phone:936-854-2857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional