Provider Demographics
NPI:1457063224
Name:BETANCUR HENAO, NATALIA (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:BETANCUR HENAO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 SPICEWOOD SPRINGS RD STE 335
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8541
Mailing Address - Country:US
Mailing Address - Phone:512-202-9471
Mailing Address - Fax:
Practice Address - Street 1:4505 SPICEWOOD SPRINGS RD STE 335
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8541
Practice Address - Country:US
Practice Address - Phone:512-202-9471
Practice Address - Fax:512-467-8658
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical