Provider Demographics
NPI:1376541607
Name:BETTS, NANCY CHARLENE (LICSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CHARLENE
Last Name:BETTS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NEWMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-2204
Mailing Address - Country:US
Mailing Address - Phone:978-465-2261
Mailing Address - Fax:978-465-2261
Practice Address - Street 1:6 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01951-2204
Practice Address - Country:US
Practice Address - Phone:978-465-2261
Practice Address - Fax:978-465-2261
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10187641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO5481Medicare ID - Type UnspecifiedLICSW